Provider Demographics
NPI:1043421035
Name:NORTHERN VALLEY ENT & FACIAL PLASTICS
Entity Type:Organization
Organization Name:NORTHERN VALLEY ENT & FACIAL PLASTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER,PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:PHILIP
Authorized Official - Last Name:SCHERL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-666-8787
Mailing Address - Street 1:219 OLD HOOK RD
Mailing Address - Street 2:
Mailing Address - City:WESTWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07675-3131
Mailing Address - Country:US
Mailing Address - Phone:201-666-8787
Mailing Address - Fax:201-358-6686
Practice Address - Street 1:163 ENGLE ST
Practice Address - Street 2:BUILDING 1B
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-2535
Practice Address - Country:US
Practice Address - Phone:201-569-6789
Practice Address - Fax:201-569-6709
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2007-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07571900207YS0123X
NJ25MA04931000207YX0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic SurgeryGroup - Single Specialty
No207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & NeckGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ527150Medicare PIN