Healthcare Provider Details

I. General information

NPI: 1134773716
Provider Name (Legal Business Name): CHILDREN'S CENTER FOR HOLISTIC HEART HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2019
Last Update Date: 07/31/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 HEMLOCK DR
PARAMUS NJ
07652-3311
US

IV. Provider business mailing address

9 HEMLOCK DR
PARAMUS NJ
07652-3311
US

V. Phone/Fax

Practice location:
  • Phone: 646-387-7000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: SUBHASHINI SUBRAMANIAN
Title or Position: PRESIDENT
Credential: MD
Phone: 646-387-7000