NPIMap

Organization Active NPI

Elite Gynecology, LLC

  • Obstetrics & Gynecology Physician
  • Clifton, NJ
National Provider Identifier
1255875183
Registry record updated Sep 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
25MA0958200 Issued in NJ
Legal business name
ELITE GYNECOLOGY, LLC
Practice address
1033 US Highway 46E Suite 105
Clifton, NJ 07013
Phone
(718) 370-2222
Fax
(718) 494-2897
NPI assigned
Dec 12, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2018

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

Authorized official

Name
Dr. Noreen Kamal-Mostafavi, MDNPI 1073748018
Title
MD
Phone
(201) 978-7146

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X 25MA0958200 NJ Primary

Addresses

Primary practice location

1033 US Highway 46E Suite 105
Clifton, NJ 07013

Mailing address

14 Bleeker Place
Staten Island, NY 10314
Phone (201) 978-7146

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1481500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1537401600000",
    "number": "1255875183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 BLEEKER PLACE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "10314",
            "telephone_number": "201-978-7146",
            "fax_number": "718-494-2897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1033 US HIGHWAY 46E SUITE 105",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "07013",
            "telephone_number": "718-370-2222",
            "fax_number": "718-494-2897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE GYNECOLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-12",
        "last_updated": "2018-09-20",
        "status": "A",
        "authorized_official_last_name": "KAMAL-MOSTAFAVI",
        "authorized_official_first_name": "NOREEN",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "201-978-7146",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "NJ",
            "license": "25MA0958200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clifton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2018; 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.