Organization
CARDIOLOGY PROFESSIONAL SERVICES AT RARITAN BAY INC
Active
Organization
CARDIOLOGY PROFESSIONAL SERVICES AT RARITAN BAY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK LEE NIEMIERA MD (OWNER)
(732) 442-1441
Entity
Organization
Contact information
Practice address
530 NEW BRUNSWICK AVE, PERTH AMBOY, NJ 08861
(732) 324-5167
Mailing address
PO BOX 447, PERTH AMBOY, NJ 08861
(732) 290-0100
(732) 583-0607
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6945503
—
NJ
Enumeration date
08/18/2006
Last updated
08/22/2020
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