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Cathedral Physician Services, P.C.

Specialist in Newark, NJ. Organization (NPI-2).

NPI number1720032964
StatusActive
Last updated in NPPESAug 22, 2020

Details

NPI
1720032964
Entity type
Organization (NPI-2)
Legal business name
Cathedral Physician Services, P.C.
Organization subpart
No
Enumeration date
May 20, 2006
Last updated
Aug 22, 2020

Medicare and OIG

Medicare enrolled (PECOS)
Not in the Medicare enrollment file
Can order and refer
Not on the CMS order and referring list
OIG exclusion list
This NPI is not listed

CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
174400000X Specialist––Yes

Practice location

111 Central Ave
3rd Floor
Newark, NJ 07102-1909

Phone 973-877-5300 · Fax 973-877-2621

Mailing address

111 Central Ave
3rd Floor
Newark, NJ 07102-1909

Phone 973-877-5300 · Fax 973-877-2621

Authorized official

Mark Connolly
Director
9738775300

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

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