NPIMap

Organization Active NPI

Roland a Ghanem,MD LLC

  • Specialist
  • Totowa, NJ
National Provider Identifier
1710277421
Registry record updated Apr 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
25MA02477700 Issued in NJ
Legal business name
ROLAND A GHANEM,MD LLC
Practice address
362 Union Blvd
Totowa, NJ 07512-2554
Phone
(973) 790-6707
NPI assigned
Apr 14, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2011

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

Authorized official

Name
Dr. Roland A Ghanem, MDNPI 1952405482
Title
Physician
Phone
(973) 790-6707

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
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 25MA02477700 NJ Primary

Addresses

Primary practice location

362 Union Blvd
Totowa, NJ 07512-2554

Mailing address

362 Union Blvd
Totowa, NJ 07512-2554
Phone (973) 790-6707

Other identifiers 1

IdentifierTypeStateIssuer
2746905MedicaidNJ

National Provider Directory

National Provider Directory

Locations

362 Union Blvd
Totowa, NJ 07512
Phone (973) 790-6707

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": "1302739200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302739200000",
    "number": "1710277421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "362 UNION BLVD",
            "city": "TOTOWA",
            "state": "NJ",
            "postal_code": "075122554",
            "telephone_number": "973-790-6707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "362 UNION BLVD",
            "city": "TOTOWA",
            "state": "NJ",
            "postal_code": "075122554",
            "telephone_number": "973-790-6707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROLAND A GHANEM,MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-14",
        "last_updated": "2011-04-14",
        "status": "A",
        "authorized_official_last_name": "GHANEM",
        "authorized_official_first_name": "ROLAND",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "973-790-6707",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NJ",
            "license": "25MA02477700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2746905",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Totowa, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2011; 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.