Provider Demographics
NPI:1437718855
Name:OPTIMUM HEART & MEDICAL CARE LLC
Entity Type:Organization
Organization Name:OPTIMUM HEART & MEDICAL CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KHALIL
Authorized Official - Middle Name:M
Authorized Official - Last Name:SUARAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-220-8011
Mailing Address - Street 1:172 SUMMERHILL RD STE 4
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-4911
Mailing Address - Country:US
Mailing Address - Phone:732-238-6440
Mailing Address - Fax:732-651-1431
Practice Address - Street 1:172 SUMMERHILL RD STE 4
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816
Practice Address - Country:US
Practice Address - Phone:732-238-6440
Practice Address - Fax:732-651-1431
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-10
Last Update Date:2019-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty