Healthcare Provider Details

I. General information

NPI: 1205791878
Provider Name (Legal Business Name): NEW JERSEY CARDIAC HEALTH MEDICAL GROUP PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

189 BERNARDO AVE
MOUNTAIN VIEW CA
94043-5138
US

IV. Provider business mailing address

100 S MULBERRY ST STE 101
DICKSON TN
37055-5023
US

V. Phone/Fax

Practice location:
  • Phone: 855-338-8800
  • Fax:
Mailing address:
  • Phone: 615-474-3314
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0404X
TaxonomyCardiac Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. JEREMY EDWARD HAAG
Title or Position: CLINICAL OPERATIONS MANAGER
Credential: CRAT
Phone: 615-474-3314