Healthcare Provider Details

I. General information

NPI: 1922212299
Provider Name (Legal Business Name): VALLEY HEART GROUP,PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2007
Last Update Date: 08/06/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 E RIDGEWOOD AVE 2ND FLOOR E WING
RIDGEWOOD NJ
07450-3957
US

IV. Provider business mailing address

1200 E RIDGEWOOD AVE 2ND FLOOR E WING
RIDGEWOOD NJ
07450-3957
US

V. Phone/Fax

Practice location:
  • Phone: 201-670-8660
  • Fax: 201-670-6693
Mailing address:
  • Phone: 201-670-8660
  • Fax: 201-670-6693

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMA51324
License Number StateNJ

VIII. Authorized Official

Name: DR. HOWARD GOLDSCHMIDT
Title or Position: MD
Credential: MD
Phone: 201-670-8660