# CARDIAC, THORACIC AND VASCULAR SURGICAL ASSOCIATE, P.A.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174652077
- **Authorized official:** DR. KENNETH N HOLWITT M.D. (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (973) 743-9900

## Contact information

- **Practice address:** 123 HIGHLAND AVE, SUITE G2, GLEN RIDGE, NJ 07028-1527
- **Practice address phone:** (973) 743-9900
- **Practice address fax:** (973) 743-3222
- **Mailing address:** 123 HIGHLAND AVE, SUITE G2, GLEN RIDGE, NJ 07028-1527
- **Mailing address phone:** (973) 743-9900
- **Mailing address fax:** (973) 743-3222

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | MA37001 | NJ | Yes |

## Other

- **Enumeration date:** 03/05/2007
- **Last updated:** 07/06/2010