Provider Demographics
NPI:1598820995
Name:ATLANTIC HEARTH RHYTHM CENTER
Entity Type:Organization
Organization Name:ATLANTIC HEARTH RHYTHM CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NADER
Authorized Official - Middle Name:N
Authorized Official - Last Name:GHALY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-748-7580
Mailing Address - Street 1:415 CHRIS GAUPP DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:GALLOWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08205-4440
Mailing Address - Country:US
Mailing Address - Phone:609-748-7580
Mailing Address - Fax:609-748-7574
Practice Address - Street 1:415 CHRIS GAUPP DR
Practice Address - Street 2:SUITE C
Practice Address - City:GALLOWAY
Practice Address - State:NJ
Practice Address - Zip Code:08205-4440
Practice Address - Country:US
Practice Address - Phone:609-748-7580
Practice Address - Fax:609-748-7574
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-26
Last Update Date:2014-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ174400000X174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5038502Medicaid
NJ078405Medicare ID - Type Unspecified
NJE65441Medicare UPIN