Healthcare Provider Details

I. General information

NPI: 1508913898
Provider Name (Legal Business Name): AMERICAN HEART CENTER PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/05/2007
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 CORLIES AVE
NEPTUNE NJ
07753-5197
US

IV. Provider business mailing address

PO BOX 1207
NEPTUNE NJ
07754-1207
US

V. Phone/Fax

Practice location:
  • Phone: 732-663-1123
  • Fax: 732-663-1179
Mailing address:
  • Phone: 732-663-1123
  • Fax: 732-663-1179

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number25MA06183300
License Number StateNJ

VIII. Authorized Official

Name: ANNE MCBAIN
Title or Position: PRACTICE ADMINISTRATOR
Credential:
Phone: 908-433-1054