Organization
CHILDRENS HEART CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. YASMIR BISAL (DIRECTOR)
(732) 557-7119
Entity
Organization
Contact information
Practice address
201 LYONS AVE, NEWARK, NJ 07112-2027
(973) 926-4900
(973) 926-2243
Mailing address
PO BOX 15328, NEWARK, NJ 07192-5328
(732) 557-7119
(732) 557-7109
Taxonomy
Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0076414
—
NJ
Enumeration date
05/04/2006
Last updated
01/23/2008
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