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Contact Information

REVASCMEDPROFESSIONAL NJ LLC
525 ROUTE 73 N STE 117
MARLTON, NJ08053-3422
 Phone: 215-575-5906
 Fax: 215-392-7992
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Interventional Cardiology

207RI0011X 11 Physician/Internal Medicine
 

Cardiovascular Disease

207RC0000X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for REVASCMEDPROFESSIONAL NJ LLC

NPI # 1154078202
LBN Legal business name REVASCMEDPROFESSIONAL NJ LLC
Authorized official JON GEORGE - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 03/08/2022
Last updated 03/08/2022 - About 4 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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