Healthcare Provider Details

I. General information

NPI: 1811929953
Provider Name (Legal Business Name): HORIZON CARDIOLOGY ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6601 VENTNOR AVE SUITE 12
VENTNOR CITY NJ
08406-2167
US

IV. Provider business mailing address

258 N NEW ROAD
PLEASANTVILLE NJ
08232
US

V. Phone/Fax

Practice location:
  • Phone: 609-887-4711
  • Fax: 608-887-4718
Mailing address:
  • Phone: 609-646-4064
  • Fax: 609-272-8526

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: ILYAS RAJPUT
Title or Position: PRESIDENT
Credential: MD
Phone: 609-646-4064