Provider Demographics
NPI:1669766143
Name:ATLANTIC HEART SPECIALISTS, LLC
Entity type:Organization
Organization Name:ATLANTIC HEART SPECIALISTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:SANJIV
Authorized Official - Middle Name:GIRISH
Authorized Official - Last Name:FALDU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-618-7424
Mailing Address - Street 1:PO BOX 5457
Mailing Address - Street 2:
Mailing Address - City:OLD BRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:08857-5457
Mailing Address - Country:US
Mailing Address - Phone:732-409-5353
Mailing Address - Fax:
Practice Address - Street 1:555 IRON BRIDGE RD
Practice Address - Street 2:SUITE 12
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-2975
Practice Address - Country:US
Practice Address - Phone:732-409-5353
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-02
Last Update Date:2012-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty