Faustino F. Estella, M.D., P.a.

Primary specialty

SpecialistTaxonomy code 174400000X

License

25MA03581700 Issued in NJ

Legal business name

FAUSTINO F. ESTELLA, M.D., P.A.

Practice address

330 Route 45
Woodstown Rd., Suite 2
Salem, NJ 08079-2034

Phone

(856) 339-9010

NPI assigned

Apr 3, 2007

Last updated

Apr 25, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Faustino F Estella, M.D.

Title

President

Phone

(856) 339-9010

Specialties & licenses 1

Addresses

Other identifiers 4

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209081600000",
    "number": "1013038108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 ROUTE 45",
            "address_2": "WOODSTOWN RD., SUITE 2",
            "city": "SALEM",
            "state": "NJ",
            "postal_code": "080792034",
            "telephone_number": "856-339-9010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 ROUTE 45",
            "address_2": "WOODSTOWN RD., SUITE 2",
            "city": "SALEM",
            "state": "NJ",
            "postal_code": "080792034",
            "telephone_number": "856-339-9010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAUSTINO F. ESTELLA, M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-03",
        "last_updated": "2008-04-25",
        "status": "A",
        "authorized_official_last_name": "ESTELLA",
        "authorized_official_first_name": "FAUSTINO",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "856-339-9010",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NJ",
            "license": "25MA03581700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH",
            "identifier": "0106063000",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0031889",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3272401",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "403663",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Salem, NJ
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• Specialist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.