NPIMap

Organization Active NPI

Ear, Nose and Throat Group of Central New Jersey

  • Plastic Surgery within the Head & Neck (Otolaryngology) Physician
  • Edison, NJ
National Provider Identifier
1669924718
Registry record updated Jun 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery within the Head & Neck (Otolaryngology) PhysicianTaxonomy code 207YX0007X
License
25MA05408700 Issued in NJ
Legal business name
EAR, NOSE AND THROAT GROUP OF CENTRAL NEW JERSEY
Practice address
2124 Oak Tree Rd FL 2
Edison, NJ 08820
Phone
(732) 205-1311
Fax
(732) 205-9648
NPI assigned
Oct 25, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2018

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

Authorized official

Name
Dr. Robert I Park, MDNPI 1710908595
Title
Ceo
Phone
(732) 205-1311

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
Plastic Surgery within the Head & Neck (Otolaryngology) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207YX0007X 25MA05408700 NJ Primary

Addresses

Primary practice location

2124 Oak Tree Rd FL 2
Edison, NJ 08820

Mailing address

23 Nevsky St
Edison, NJ 08820-2425
Phone (732) 205-1311

Other names 1

  • ear, nose and throat group of cnj Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ear Nose and Throat Group of Central New Jersey2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

23 Nevsky St
Edison, NJ 08820
Phone (732) 549-2273

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": "1477353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1530057600000",
    "number": "1669924718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 NEVSKY ST",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088202425",
            "telephone_number": "732-205-1311",
            "fax_number": "732-205-9648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2124 OAK TREE RD FL 2",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "08820",
            "telephone_number": "732-205-1311",
            "fax_number": "732-205-9648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAR, NOSE AND THROAT GROUP OF CENTRAL NEW JERSEY",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-25",
        "last_updated": "2018-06-27",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "732-205-1311",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207YX0007X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology, Plastic Surgery within the Head & Neck",
            "state": "NJ",
            "license": "25MA05408700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ear, nose and throat group of cnj",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Edison, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 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.