Clifton Physician Assistant LLC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

25MP00383100 Issued in NJ

Legal business name

CLIFTON PHYSICIAN ASSISTANT LLC

Practice address

1033 Route 46
Suite 102
Clifton, NJ 07013-2473

Phone

(973) 779-7979

Fax

(973) 779-7970

NPI assigned

Feb 1, 2016

Last updated

Feb 1, 2016By 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. Charles G Haddad, M.D.NPI 1750329538

Title

Member/ Manager

Phone

(973) 779-7979

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Charles George Haddad, M.D.

  • Obstetrics & Gynecology Physician
  • Clifton, NJ
  • NPI 1750329538
  Authorized official Same address or phone

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

{
    "created_epoch": "1454284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454284800000",
    "number": "1174981484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1033 ROUTE 46",
            "address_2": "SUITE 102",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070132473",
            "telephone_number": "973-779-7979",
            "fax_number": "973-779-7970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1033 ROUTE 46",
            "address_2": "SUITE 102",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070132473",
            "telephone_number": "973-779-7979",
            "fax_number": "973-779-7970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLIFTON PHYSICIAN ASSISTANT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-01",
        "last_updated": "2016-02-01",
        "status": "A",
        "authorized_official_last_name": "HADDAD",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "MEMBER/ MANAGER",
        "authorized_official_telephone_number": "973-779-7979",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00383100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physician Assistant in Clifton, NJ
• Providers in Clifton, NJ by specialty
• Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2016; 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.