Healthcare Provider Details

I. General information

NPI: 1295837748
Provider Name (Legal Business Name): HEART CENTER OF HUDSON COUNTY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2006
Last Update Date: 11/05/2024
Certification Date: 11/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1625 JFK BLVD
NORTH BERGEN NJ
07047
US

IV. Provider business mailing address

600 PAVONIA AVE FL 5
JERSEY CITY NJ
07306-2929
US

V. Phone/Fax

Practice location:
  • Phone: 201-216-3060
  • Fax: 201-499-0253
Mailing address:
  • Phone: 201-216-3060
  • Fax: 201-499-0253

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: BAKUL DESAI
Title or Position: PRESIDENT
Credential: MD
Phone: 201-216-3060