Organization Active NPI

Ear, Nose & Throat Center of NJ

  • Otolaryngology Physician
  • Nutley, NJ
National Provider Identifier
1821276478
Registry record updated Apr 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
EAR, NOSE & THROAT CENTER OF NJ
Practice address
115 Franklin Ave
Nutley, NJ 07110-2924
Phone
(973) 773-9250
Fax
(973) 773-9525
NPI assigned
Feb 6, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2012

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

Authorized official

Name
Dr. Oliver YoussefNPI 1801826219
Title
Physician
Phone
(973) 773-9250

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
Otolaryngology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Y00000X Primary

Addresses

Primary practice location

115 Franklin Ave
Nutley, NJ 07110-2924

Mailing address

115 Franklin Ave
Nutley, NJ 07110-2924
Phone (973) 773-9250

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040309000946 NJ Part B Supplier - Clinic/Group Practice 8426946542 Receives reassigned benefits from 3 practitioners
Practice locations: Nutley, NJ

National Provider Directory

National Provider Directory

Locations

50 Newark Ave
Ste 108
Belleville, NJ 07109
Phone (646) 632-2997

925 Clifton Ave
Ste 204
Clifton, NJ 07013
Phone (973) 772-6111

5 Summit Ave
Fl 1
Hackensack, NJ 07601
Phone (973) 772-6111

115 Franklin Ave
Nutley, NJ 07110
Phone (973) 772-6111

Practitioners & affiliated clinicians

Practitioners 6

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": "1202256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334707200000",
    "number": "1821276478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 FRANKLIN AVE",
            "city": "NUTLEY",
            "state": "NJ",
            "postal_code": "071102924",
            "telephone_number": "973-773-9250",
            "fax_number": "973-773-9525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 FRANKLIN AVE",
            "city": "NUTLEY",
            "state": "NJ",
            "postal_code": "071102924",
            "telephone_number": "973-773-9250",
            "fax_number": "973-773-9525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAR, NOSE & THROAT CENTER OF NJ",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-06",
        "last_updated": "2012-04-18",
        "status": "A",
        "authorized_official_last_name": "YOUSSEF",
        "authorized_official_first_name": "OLIVER",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "973-773-9250",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nutley, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2012; 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.