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General NPI Number Information
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NPI Number | 1164850210
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Entity Type | Organization
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Legal Business Name | NJ HEART MEDICAL ASSOCIATES LLC
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Dates
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Enumeration Date | 10/29/2013
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Last Update Date | 10/31/2013
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Provider Practice Location Address
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Address Line | 48 PULASKI AVE
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City | CARTERET
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State | NJ
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Zip | 07008-2509
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Country | US
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Telephone | 917-270-6050
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Fax |
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Provider Business Mailing Address
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Address Line | 48 PULASKI AVE
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City | CARTERET
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State | NJ
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Zip | 07008-2509
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Country | US
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Telephone | 917-270-6050
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | OSAMA FARID
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Credential | PA
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Telephone | 917-270-6050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 25MP00164800
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License Number State | NJ
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