Organization Active NPI

Seton Hall University

  • Family Medicine Physician
  • South Orange, NJ
National Provider Identifier
1366676702
Registry record updated May 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SETON HALL UNIVERSITY
Practice address
400 S Orange Ave
South Orange, NJ 07079-2646
Phone
(973) 761-9175
Fax
(973) 761-9193
NPI assigned
May 13, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2009

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

Authorized official

Name
Joan Osthues
Title
Director, Health Services
Phone
(973) 761-9175

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Adult Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LA2200X
Pediatric Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0200X

Addresses

Primary practice location

400 S Orange Ave
South Orange, NJ 07079-2646

Mailing address

400 S Orange Ave
South Orange, NJ 07079-2646
Phone (973) 761-9175

Other names 1

  • Seton Hall University Health Services Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
31D2200084Seton Hall University Sports Medicine400 South Orange Avenue, South Orange, NJ 07079Certificate of waiverNov 12, 2026

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1242172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242172800000",
    "number": "1366676702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 S ORANGE AVE",
            "city": "SOUTH ORANGE",
            "state": "NJ",
            "postal_code": "070792646",
            "telephone_number": "973-761-9175",
            "fax_number": "973-761-9193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 S ORANGE AVE",
            "city": "SOUTH ORANGE",
            "state": "NJ",
            "postal_code": "070792646",
            "telephone_number": "973-761-9175",
            "fax_number": "973-761-9193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SETON HALL UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-13",
        "last_updated": "2009-05-13",
        "status": "A",
        "authorized_official_last_name": "OSTHUES",
        "authorized_official_first_name": "JOAN",
        "authorized_official_title_or_position": "DIRECTOR, HEALTH SERVICES",
        "authorized_official_telephone_number": "973-761-9175"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Seton Hall University Health Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in South Orange, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.

Verify at the official NPI Registry.