1649969130 NPI number — NEW HEART LABS DIAGNOSTICS AND SCREENING

Table of content: (NPI 1649969130)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649969130 NPI number — NEW HEART LABS DIAGNOSTICS AND SCREENING

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEW HEART LABS DIAGNOSTICS AND SCREENING
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1649969130
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/02/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
202 UNION ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GLASSBORO
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08028-5100
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
856-279-3145
Provider Business Mailing Address Fax Number:
856-854-4300

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
833 HADDON AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COLLINGSWOOD
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08108-1923
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
856-279-3145
Provider Business Practice Location Address Fax Number:
856-854-4300
Provider Enumeration Date:
05/02/2023

Additional Information

Authorized Official

Authorized Official Last Name:
FLETCHER
Authorized Official First Name:
AMY
Authorized Official Middle Name:
MARIE
Authorized Official Title or Position:
FNP
Authorized Official Telephone Number:
856-279-3145

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com