Provider Demographics
NPI:1144437443
Name:HEART-TO-HEART PEDIATRIC CARDIOLOGY, INC.
Entity type:Organization
Organization Name:HEART-TO-HEART PEDIATRIC CARDIOLOGY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SADAF
Authorized Official - Middle Name:A
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-333-7689
Mailing Address - Street 1:981 ROUTE 33 WEST
Mailing Address - Street 2:SUITE A
Mailing Address - City:MONROE TWP.
Mailing Address - State:NJ
Mailing Address - Zip Code:08831-5923
Mailing Address - Country:US
Mailing Address - Phone:732-333-7689
Mailing Address - Fax:609-490-1187
Practice Address - Street 1:981 ROUTE 33 WEST
Practice Address - Street 2:SUITE A
Practice Address - City:MONROE TWP.
Practice Address - State:NJ
Practice Address - Zip Code:08831-5923
Practice Address - Country:US
Practice Address - Phone:732-333-7689
Practice Address - Fax:609-490-1187
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2009-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07863700208000000X, 2080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric CardiologyGroup - Single Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0074969Medicaid
PA101339653Medicaid
PA101339653Medicaid
PA091844Medicare ID - Type Unspecified
NJ093081Medicare ID - Type Unspecified