CATHEDRAL CARDIAC SPECIALISTS, PC (NPI# 1790739993) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790739993 |
| Entity Type | Organization |
| Organization Name | CATHEDRAL CARDIAC SPECIALISTS, PC |
| Practice Address |
111 Central Ave 3rd Floor Newark NJ 07102-1909 |
| Practice Telephone | 9738775300 |
| Practice Fax Number | 9738772621 |
| Mailing Telephone | 9738775300 |
| Mailing Fax Number | 9738772621 |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. MARK CONNOLLY (DIRECTOR) |
| Authorized Official Telephone | 9738775300 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | Allopathic & Osteopathic Physicians | ||
| X | 207RC0200X |
Internal Medicine Specialization: Critical Care Medicine |
Allopathic & Osteopathic Physicians |
| Street Address |
111 CENTRAL AVE 3RD FLOOR |
| City | NEWARK |
| State | NJ |
| Zip Code | 07102-1909 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780687806 | Sandhya R Makkapati | Specialist | 111 Central Ave, Newark, NJ 07102-1909 | 2005-05-23 |
| 1740892496 | Stella Monday Wangai | Nurse Practitioner | 111 Central Ave, Newark, NJ 07102-1909 | 2020-08-22 |
| 1144832932 | Sonya Wali | Student in an Organized Health Care Education/Training Program | 111 Central Ave, Newark, NJ 07102-1909 | 2020-08-21 |
| 1023620358 | Chrystina Mildred Kiwan | Student in an Organized Health Care Education/Training Program | 111 Central Ave, Newark, NJ 07102-1909 | 2020-08-18 |
| 1518579838 | Alicia Kovach | Student in an Organized Health Care Education/Training Program | 111 Central Ave, Newark, NJ 07102-1909 | 2020-08-18 |
| 1861003659 | Riyashat Kazmi | Student in an Organized Health Care Education/Training Program | 111 Central Ave, Newark, NJ 07102-1909 | 2020-08-13 |
| 1114537610 | Kalee Larsen | Student in an Organized Health Care Education/Training Program | 111 Central Ave, Newark, NJ 07102-1909 | 2020-08-09 |
| 1215547567 | Nirav Patel | Student in an Organized Health Care Education/Training Program | 111 Central Ave, Newark, NJ 07102-1909 | 2020-08-02 |
| 1720697238 | Sneha Bijoy | Student in an Organized Health Care Education/Training Program | 111 Central Ave, Newark, NJ 07102-1909 | 2020-07-30 |
| 1407465891 | Ruhma Ali | Student in an Organized Health Care Education/Training Program | 111 Central Ave, Newark, NJ 07102-1909 | 2020-07-30 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487253779 | Integrity, Inc | Clinic/Center | 1091-1093 Broad Street, Newark, NJ 07102 | 2020-10-19 |
| 1881292720 | Oluwaseun Ademulegun | Pharmacist | 1084 Broad Street, Newark, Newark, NJ 07102 | 2020-10-13 |
| 1679042295 | Henry Paul Grayner | Specialist/Technologist | 100 Lock St, Newark, NJ 07102 | 2018-11-14 |
| 1548736838 | Integrity, Inc | Substance Abuse Rehabilitation Facility | 101 Lincoln Park, 2nd Floor, Newark, NJ 07102 | 2018-10-15 |
| 1962981407 | Crystal Kay-baune Mccown | Social Worker | 130 Orange St, Newark, NJ 07102 | 2018-08-07 |
| 1053808865 | Nubi Consultants Corp. Dba Aplus Home Care | Physical Therapist | 11 Franklin Street, 11 Franklin Street, Newark, NJ 07102 | 2018-04-17 |
| 1396249264 | Integrity, Inc | Substance Abuse Rehabilitation Facility | 49 Lincoln Park, Newark, NJ 07102 | 2018-03-23 |
| 1568960896 | Saint James Health Inc | Clinic/Center | 36 Halsey Street, Newark, NJ 07102 | 2018-02-01 |
| 1992216527 | Metropolitan Center for Human Services | Psychologist | 520 Dr. Martin Luther King, Jr. Boulevard, Newark, NJ 07102 | 2017-10-23 |
| 1467974949 | Ahmad Mohammad Tawfiq Damati | Student in an Organized Health Care Education/Training Program | 123 University Ave, Newark, Nj 07102, Newark, NJ 07102 | 2017-07-17 |
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| Taxonomy Code | 208G00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Thoracic Surgery (Cardiothoracic Vascular Surgery) |
| A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Thoracic Surgery, 2007. http://www.abts.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Thoracic Surgery. Thoracic surgeons have the knowledge, experience and technical skills to accurately diagnose, operate upon safely, and effectively manage patients with thoracic diseases of the chest. This requires substantial knowledge of cardiorespiratory physiology and oncology, as well as capability in the use of heart assist devices, management of abnormal heart rhythms and drainage of the chest cavity, respiratory support systems, endoscopy and invasive and noninvasive diagnostic techniques. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003850504 | Christiana Care Health Services, Inc | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 200 Hygeia Dr Ste 1360, Newark, DE 19713-2049 | 2006-06-15 |
| 1720268584 | Constantinos J Lovoulos | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 150 Bergen St, Uh F-102, Newark, NJ 07103-2496 | 2007-11-09 |
| 1255465571 | Charles R Mulligan Jr. | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 4701 Ogletown Stanton Road, Helen F. Graham Cancer Center, Suite 2100, Newark, DE 19713 | 2007-03-16 |
| 1063568665 | Sunil Prakash Malhotra | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 201 Lyons Ave, Suite L5, Newark, NJ 07112-2027 | 2007-01-26 |
| 1760566855 | Chandra Shekhar R Beesam | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 4735 Ogletown Stanton Rd, Map 2, Suite 1201& 1205, Newark, DE 19713-2072 | 2006-10-25 |
| 1811085152 | Hisham M.f. Sherif | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 4755 Ogletown Stanton Rd, Suite 1e50, Newark, DE 19805-7170 | 2006-10-11 |
| 1487742706 | David J Polidori | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 4735 Ogletown Stanton Rd, Map 2, Suite 1201& 1205, Newark, DE 19713-2072 | 2006-10-11 |
| 1326139353 | Katrhleen Winifred Mcnicholas | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 4755 Ogletown Stanton Rd, 1e50, Newark, DE 19718-0002 | 2006-09-27 |
| 1033200084 | Ray A Blackwell | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 4755 Ogletown Stanton Rd, Suite 1e50, Newark, DE 19718-0002 | 2006-09-27 |
| 1891723581 | Michael K Banbury | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 4755 Ogletown Stanton Rd, Suite 1e50, Newark, DE 19718 | 2006-06-29 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.