Organization Active NPI

Niccollai Medical Practice

  • Primary Care Clinic/Center
  • Little Falls, NJ
National Provider Identifier
1639259138
Registry record updated Sep 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
82307 Issued in NJ
Legal business name
NICCOLLAI MEDICAL PRACTICE
Practice address
219 Paterson Ave
Little Falls, NJ 07424-1657
Phone
(973) 890-0855
Fax
(973) 890-0025
NPI assigned
Oct 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2008

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

Authorized official

Name
Dr. Munzer Arnouk, M.D.NPI 1841271939
Title
Doctor
Phone
(973) 890-0855

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
Primary Care Clinic/Center 261QP2300X 82307 NJ Primary

Addresses

Primary practice location

219 Paterson Ave
Little Falls, NJ 07424-1657

Mailing address

219 Paterson Ave
Little Falls, NJ 07424-1657
Phone (973) 890-0855

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120726000510 NJ Part B Supplier - Clinic/Group Practice 2567628183 Receives reassigned benefits from 1 practitioner
Practice locations: Little Falls, NJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221523200000",
    "number": "1639259138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 PATERSON AVE",
            "city": "LITTLE FALLS",
            "state": "NJ",
            "postal_code": "074241657",
            "telephone_number": "973-890-0855",
            "fax_number": "973-890-0025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 PATERSON AVE",
            "city": "LITTLE FALLS",
            "state": "NJ",
            "postal_code": "074241657",
            "telephone_number": "973-890-0855",
            "fax_number": "973-890-0025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NICCOLLAI MEDICAL PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2008-09-16",
        "status": "A",
        "authorized_official_last_name": "ARNOUK",
        "authorized_official_first_name": "MUNZER",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "973-890-0855",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NJ",
            "license": "82307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Falls, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2008; 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.