Organization Active NPI

Holistic OB/GYN, LLC

  • Advanced Practice Midwife
  • Clifton, NJ
National Provider Identifier
1710320239
Registry record updated May 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
25ME00038301 Issued in NJ
Legal business name
HOLISTIC OB/GYN, LLC
Practice address
1700 Route 3
Clifton, NJ 07013-3928
Phone
(973) 747-5217
Fax
(973) 396-8832
NPI assigned
Apr 15, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 7, 2014

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

Authorized official

Name
Ms. Paola A Escobar, M.S.N., C.N.M
Title
Owner
Phone
(973) 747-5217

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice MidwifeGroup: 193400000X SINGLE SPECIALTY GROUP 367A00000X 25ME00038301 NJ Primary

Addresses

Primary practice location

1700 Route 3
Clifton, NJ 07013-3928

Mailing address

PO Box 6072
Clifton, NJ 07015-6072
Phone (973) 747-5217

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140424000309 NJ Part B Supplier - Clinic/Group Practice 1557594702 Receives reassigned benefits from 1 practitioner
Practice locations: Clifton, NJ

National Provider Directory

National Provider Directory

Locations

764 Main St
Ste 201
Paterson, NJ 07503

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": "1365984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399420800000",
    "number": "1710320239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6072",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070156072",
            "telephone_number": "973-747-5217",
            "fax_number": "973-396-8832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 ROUTE 3",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070133928",
            "telephone_number": "973-747-5217",
            "fax_number": "973-396-8832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLISTIC OB/GYN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-15",
        "last_updated": "2014-05-07",
        "status": "A",
        "authorized_official_last_name": "ESCOBAR",
        "authorized_official_first_name": "PAOLA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-747-5217",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "M.S.N., C.N.M"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Advanced Practice Midwife",
            "state": "NJ",
            "license": "25ME00038301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clifton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2014; 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.