Provider Demographics
NPI:1164850210
Name:NJ HEART MEDICAL ASSOCIATES LLC
Entity Type:Organization
Organization Name:NJ HEART MEDICAL ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:OSAMA
Authorized Official - Middle Name:
Authorized Official - Last Name:FARID
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:917-270-6050
Mailing Address - Street 1:48 PULASKI AVE
Mailing Address - Street 2:
Mailing Address - City:CARTERET
Mailing Address - State:NJ
Mailing Address - Zip Code:07008-2509
Mailing Address - Country:US
Mailing Address - Phone:917-270-6050
Mailing Address - Fax:
Practice Address - Street 1:48 PULASKI AVE
Practice Address - Street 2:
Practice Address - City:CARTERET
Practice Address - State:NJ
Practice Address - Zip Code:07008-2509
Practice Address - Country:US
Practice Address - Phone:917-270-6050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-29
Last Update Date:2013-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00164800207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty