Organization
MAINLAND HEART CONSULTANTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JENNIFER E GANSERT (ADMINSTRATOR)
(609) 404-9900
Entity
Organization
Contact information
Practice address
318 CHRIS GAUPP DR, GALLOWAY, NJ 08205-4460
(609) 404-9900
(609) 404-3653
Mailing address
318 CHRIS GAUPP DR, GALLOWAY, NJ 08205-4460
(609) 404-9900
(609) 404-3653
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0364554000
AMERIHEALTH
NJ
01
—
605324
AETNA
NJ
01
—
G537870
OXFORD
NJ
Enumeration date
07/17/2006
Last updated
10/19/2010
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