Provider Demographics
NPI:1124341516
Name:HEART JERSEY CITY
Entity type:Organization
Organization Name:HEART JERSEY CITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:MUHAMMED
Authorized Official - Middle Name:Z
Authorized Official - Last Name:IQBAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-216-3060
Mailing Address - Street 1:600 PAVONIA AVE
Mailing Address - Street 2:5TH FL
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07306-2929
Mailing Address - Country:US
Mailing Address - Phone:201-216-3060
Mailing Address - Fax:201-499-0253
Practice Address - Street 1:600 PAVONIA AVE
Practice Address - Street 2:5TH FL
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-2929
Practice Address - Country:US
Practice Address - Phone:201-216-3060
Practice Address - Fax:201-499-0253
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-12
Last Update Date:2010-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06054000207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ575676OtherMEDCARE PTAN
NJ6837107Medicaid
NJ6837107Medicaid