Provider Demographics
NPI:1629133491
Name:HEART FAILURE SPECIALISTS PA
Entity Type:Organization
Organization Name:HEART FAILURE SPECIALISTS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:L
Authorized Official - Last Name:BERKOWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-996-4849
Mailing Address - Street 1:20 PROSPECT AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-1997
Mailing Address - Country:US
Mailing Address - Phone:551-996-4849
Mailing Address - Fax:551-996-5703
Practice Address - Street 1:20 PROSPECT AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-1997
Practice Address - Country:US
Practice Address - Phone:551-996-4849
Practice Address - Fax:551-996-5703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-22
Last Update Date:2013-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05291700174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0868604Medicaid
NJ0868604Medicaid
A64387Medicare UPIN
NJA64387Medicare UPIN