Organization Active NPI

Omnj Division Two LLC

  • Anesthesiology Physician
  • New York, NY
National Provider Identifier
1437963840
Registry record updated Feb 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
OMNJ DIVISION TWO LLC
Practice address
694 Main St # 257
New York, NY 10044-0027
Phone
(718) 255-6391
Fax
(718) 255-6392
NPI assigned
Feb 5, 2025
Last updated
Feb 5, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2025

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

Authorized official

Name
Harshvardhan Chaobal, DONPI 1558401679
Title
Owner
Phone
(718) 255-6391

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
Anesthesiology Physician 207L00000X NU Primary

Addresses

Primary practice location

694 Main St # 257
New York, NY 10044-0027

Mailing address

694 Main St # 257
New York, NY 10044-0027
Phone (718) 255-6391

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251001001388 NJ Part B Supplier - Clinic/Group Practice 7416453253 Receives reassigned benefits from 5 practitioners
Practice locations: Hackensack, NJ

National Provider Directory

National Provider Directory

Locations

146 N State Rt 17
Ste A1
Hackensack, NJ 07601
Phone (551) 999-9064

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1738713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738713600000",
    "number": "1437963840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "694 MAIN ST # 257",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100440027",
            "telephone_number": "718-255-6391",
            "fax_number": "718-255-6392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "694 MAIN ST # 257",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100440027",
            "telephone_number": "718-255-6391",
            "fax_number": "718-255-6392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMNJ DIVISION TWO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-05",
        "last_updated": "2025-02-05",
        "certification_date": "2025-02-05",
        "status": "A",
        "authorized_official_last_name": "CHAOBAL",
        "authorized_official_first_name": "HARSHVARDHAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-255-6391",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.