Provider Demographics
NPI:1922212299
Name:VALLEY HEART GROUP,PA
Entity Type:Organization
Organization Name:VALLEY HEART GROUP,PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLDSCHMIDT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-670-8660
Mailing Address - Street 1:1200 E RIDGEWOOD AVE
Mailing Address - Street 2:2ND FLOOR E WING
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07450-3957
Mailing Address - Country:US
Mailing Address - Phone:201-670-8660
Mailing Address - Fax:201-670-6693
Practice Address - Street 1:1200 E RIDGEWOOD AVE
Practice Address - Street 2:2ND FLOOR E WING
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450-3957
Practice Address - Country:US
Practice Address - Phone:201-670-8660
Practice Address - Fax:201-670-6693
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-09
Last Update Date:2010-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA51324174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJCC3639OtherRAILROAD MEDICARE
NJCC3639OtherRAILROAD MEDICARE