Healthcare Provider Details

I. General information

NPI: 1184950461
Provider Name (Legal Business Name): SHORE HEART GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2009
Last Update Date: 10/21/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1820 STATE ROUTE 33 SUITE 4B
NEPTUNE NJ
07753-4860
US

IV. Provider business mailing address

1820 STATE ROUTE 33 SUITE 4B
NEPTUNE NJ
07753-4860
US

V. Phone/Fax

Practice location:
  • Phone: 732-776-8500
  • Fax: 732-776-8946
Mailing address:
  • Phone: 732-776-8500
  • Fax: 732-776-8946

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code207UN0901X
TaxonomyNuclear Cardiology Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MAURICE D WEISS
Title or Position: PRESIDENT
Credential: M.D.
Phone: 732-776-8500