Active NPI
Cliffside Medical LLC
- Dermatology Physician
- Cliffside Park, NJ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- Legal business name
- CLIFFSIDE MEDICAL LLC
- Practice address
- 663 Palisade Ave
Cliffside Park, NJ 07010-3012 - Phone
- (201) 945-6500
- Fax
- (201) 945-1157
- NPI assigned
- Oct 20, 2006
- Last updated
- Oct 11, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Benjamin S Chouake, M.D.
- Title
- President
- Phone
- (201) 945-6500
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 7
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | Primary | ||
| Emergency Medicine Physician | 207P00000X | |||
| Family Medicine Physician | 207Q00000X | |||
| Internal Medicine Physician | 207R00000X | |||
| Physical Medicine & Rehabilitation Physician | 208100000X | |||
| Diagnostic Radiology Physician | 2085R0202X | |||
| General Practice Physician | 208D00000X |
Addresses
Primary practice location
663 Palisade Ave
Cliffside Park, NJ 07010-3012
Mailing address
663 Palisade Ave Ste 101
Cliffside Park, NJ 07010-3098
Phone (201) 945-6500
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
Enrollment records 2
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 31D0677093 | Cliffside Medical Emergimed Laboratory | Compliance | Sep 15, 2026 |
National Provider Directory
National Provider DirectoryLocations
663 Palisade Ave
Ste 101
Cliffside Pk, NJ 07010
Phone (201) 917-2246
Practitioners & affiliated clinicians
Practitioners 10
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Internal Medicine Physician
- Cliffside Park, NJ
- NPI 1891804654
-
- Dermatology Physician
- Cliffside Park, NJ
- NPI 1891135943
-
- Cardiovascular Disease Physician
- Teaneck, NJ
- NPI 1699774950
-
- Gastroenterology Physician
- Cliffside Park, NJ
- NPI 1205945086
-
- General Practice Physician
- Cliffside Park, NJ
- NPI 1902020373
-
- Family Nurse Practitioner
- Cliffside Park, NJ
- NPI 1689130254
-
- Gastroenterology Physician
- Englewood, NJ
- NPI 1285668376
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161302400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1696982400000",
"number": "1104908813",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "663 PALISADE AVE STE 101",
"city": "CLIFFSIDE PARK",
"state": "NJ",
"postal_code": "070103098",
"telephone_number": "201-945-6500",
"fax_number": "201-945-1157"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "663 PALISADE AVE",
"city": "CLIFFSIDE PARK",
"state": "NJ",
"postal_code": "070103012",
"telephone_number": "201-945-6500",
"fax_number": "201-945-1157"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CLIFFSIDE MEDICAL LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-10-20",
"last_updated": "2023-10-11",
"certification_date": "2023-10-11",
"status": "A",
"authorized_official_last_name": "CHOUAKE",
"authorized_official_first_name": "BENJAMIN",
"authorized_official_middle_name": "S",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "201-945-6500",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dermatology",
"state": null,
"license": null,
"primary": true
},
{
"code": "207P00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Emergency Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "208100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Medicine & Rehabilitation",
"state": null,
"license": null,
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Radiology, Diagnostic Radiology",
"state": null,
"license": null,
"primary": false
},
{
"code": "208D00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "General Practice",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Cliffside Park, NJ
- Constantine G Christolias, DDS DOCTOR OF DENTIS
- Thomas Chun, MD
- Steven S Chung, L.AC
- Barbara Cirignano, MD
- Cliffside Eye Center L L C
- Cliffside Park Chiropractic
- Cliffside Park Imaging and Diagnostic Center, LLC
- Cliffside Park Pharmacy LLC
- Cliffside Park Public Schools
- Cliffside Physical Therapy & Chiropractic Center PC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.