Healthcare Provider Details

I. General information

NPI: 1861844136
Provider Name (Legal Business Name): PAURUSH AMBESH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2016
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 NEPTUNE BLVD STE 101
NEPTUNE NJ
07753-4848
US

IV. Provider business mailing address

120 WHITE HORSE PIKE STE 112
HADDON HEIGHTS NJ
08035-1938
US

V. Phone/Fax

Practice location:
  • Phone: 732-776-8500
  • Fax: 732-776-8946
Mailing address:
  • Phone: 856-547-0539
  • Fax: 856-547-3178

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number25MA12643000
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number25MA12643000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: