Provider Demographics
NPI:1881651081
Name:THE HEART GROUP,P.A
Entity Type:Organization
Organization Name:THE HEART GROUP,P.A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING SUPERVISOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:L
Authorized Official - Last Name:GAVIRIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-467-3620
Mailing Address - Street 1:161 MILLBURN AVE
Mailing Address - Street 2:
Mailing Address - City:MILLBURN
Mailing Address - State:NJ
Mailing Address - Zip Code:07041-1825
Mailing Address - Country:US
Mailing Address - Phone:973-467-4220
Mailing Address - Fax:973-467-9889
Practice Address - Street 1:161 MILLBURN AVE
Practice Address - Street 2:
Practice Address - City:MILLBURN
Practice Address - State:NJ
Practice Address - Zip Code:07041-1825
Practice Address - Country:US
Practice Address - Phone:973-467-4220
Practice Address - Fax:973-467-9889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04071400174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty