Newark Beth Israel

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

NEWARK BETH ISRAEL

Practice address

201 Lyons Ave
Newark, NJ 07112-2027

Phone

(973) 926-7000

NPI assigned

Mar 29, 2024

Organization subpart

No

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

Authorized official

Name

Ebonni Shaw

Title

Pediatric Residency Coordinator

Phone

(973) 926-2676

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jennifer S Dally, MD

  • Student in an Organized Health Care Education/Training Program
  • Newark, NJ
  • NPI 1134959174
  NPD

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

{
    "created_epoch": "1711670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711670400000",
    "number": "1245081918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 LYONS AVE",
            "address_2": "OFFICE OF GRADUATE MEDICAL EDUCATION - EBONNIE SHAW",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071122027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 LYONS AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071122027",
            "telephone_number": "973-926-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEWARK BETH ISRAEL",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-29",
        "last_updated": "2024-03-29",
        "certification_date": "2024-03-29",
        "status": "A",
        "authorized_official_last_name": "SHAW",
        "authorized_official_first_name": "EBONNI",
        "authorized_official_title_or_position": "PEDIATRIC RESIDENCY COORDINATOR",
        "authorized_official_telephone_number": "973-926-2676"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• New Jersey Podiatric Physicians and Surgeons Group, LLC
• New Journey Wellness Center LLC
• New Leaf Recovery Ministry
• Newark Acupucnture Wellness PC
• Newark AIDS Consortium, Inc
• Newark Beth Israel Emergency Medical Associates LLC
• Newark Beth Israel Emergency Room Department
• Newark Beth Israel Hospital
• Newark Beth Israel Medical Center
• Newark Beth Israel Medical Center

• Pediatrics Physician in Newark, NJ
• Providers in Newark, NJ by specialty
• Pediatrics Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2024; 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.