Provider Demographics
NPI:1588277503
Name:ADVANCED HEART AND VASCULAR OF CENTRAL JERSEY
Entity type:Organization
Organization Name:ADVANCED HEART AND VASCULAR OF CENTRAL JERSEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:FARRUGIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-535-2765
Mailing Address - Street 1:PO BOX 1230
Mailing Address - Street 2:
Mailing Address - City:EATONTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07724-5230
Mailing Address - Country:US
Mailing Address - Phone:732-383-4200
Mailing Address - Fax:732-741-1895
Practice Address - Street 1:340 ROUTE 34 STE 201
Practice Address - Street 2:
Practice Address - City:COLTS NECK
Practice Address - State:NJ
Practice Address - Zip Code:07722-2434
Practice Address - Country:US
Practice Address - Phone:732-487-3636
Practice Address - Fax:732-487-3635
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-28
Last Update Date:2020-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0286087Medicaid