MEDICARE: HAMILTON HEART & VASCULAR CARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RI0011X	Interventional Cardiology Physician

General Provider Information

NPI Number	:	1386119014
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HAMILTON HEART & VASCULAR CARE LLC

Provider Business Mailing Address
First Line	:	3379 QUAKERBRIDGE RD STE 200
Second Line	:
City	:	HAMILTON
State	:	NJ
Zip	:	08619-1269
Country	:	US
Telephone Number	:	215-747-4511
Fax Number	:	215-476-1427

Provider Business Practice Location Address
First Line	:	3379 QUAKERBRIDGE RD STE 200
Second Line	:
City	:	HAMILTON
State	:	NJ
Zip	:	08619-1269
Country	:	US
Telephone Number	:	215-747-4511
Fax Number	:	215-476-1427

Authorized Official
Title or Position	:	OWNER
Name	:	HAYTHAM ALBIZEM
Credential	:	MD
Telephone Number	:	215-747-4511

Provider Enumeration Date	:	10/09/2018
Last Update Date	:	10/09/2018

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