Organization Active NPI

Raphael Osheroff, M.D, P.a.

  • General Practice Physician
  • Clifton, NJ
National Provider Identifier
1891913141
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
25MA06156400 Issued in NJ
Legal business name
RAPHAEL OSHEROFF, M.D, P.A.
Practice address
385 Lakeview Ave
Clifton, NJ 07011-4035
Phone
(973) 928-2777
Fax
(973) 928-2776
NPI assigned
Apr 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Authorized official

Name
Dr. Raphael J Osheroff, M.D.
Title
Medical Director
Phone
(973) 928-2777

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X 25MA06156400 NJ Primary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X 175535-1 NY

Addresses

Primary practice location

385 Lakeview Ave
Clifton, NJ 07011-4035

Mailing address

2 Hamilton Ave
Cranford, NJ 07016-2427
Phone (973) 928-2777

Other identifiers 1

IdentifierTypeStateIssuer
6919600MedicaidNJ

National Provider Directory

National Provider Directory

Locations

385 Lakeview Ave
Ste 1
Clifton, NJ 07011
Phone (973) 928-2777

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1891913141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 HAMILTON AVE",
            "city": "CRANFORD",
            "state": "NJ",
            "postal_code": "070162427",
            "telephone_number": "973-928-2777",
            "fax_number": "973-928-2776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "385 LAKEVIEW AVE",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070114035",
            "telephone_number": "973-928-2777",
            "fax_number": "973-928-2776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAPHAEL OSHEROFF, M.D, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-23",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "OSHEROFF",
        "authorized_official_first_name": "RAPHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "973-928-2777",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "NJ",
            "license": "25MA06156400",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "NY",
            "license": "175535-1",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6919600",
            "state": "NJ"
        }
    ],
    "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 Mar 7, 2023; 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.