Provider Demographics
NPI:1275690059
Name:FAMILY CENTER FOR OTOLARYNGOLOGY INC
Entity Type:Organization
Organization Name:FAMILY CENTER FOR OTOLARYNGOLOGY INC
Other - Org Name:THE FAMILY CENTER FOR OTOLARYNGOLOGY INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:SARTI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-935-5508
Mailing Address - Street 1:47 ORIENT WAY
Mailing Address - Street 2:LOWER LEVEL
Mailing Address - City:RUTHERFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07070
Mailing Address - Country:US
Mailing Address - Phone:201-935-5508
Mailing Address - Fax:201-935-4166
Practice Address - Street 1:47 ORIENT WAY
Practice Address - Street 2:LOWER LEVEL
Practice Address - City:RUTHERFORD
Practice Address - State:NJ
Practice Address - Zip Code:07070
Practice Address - Country:US
Practice Address - Phone:201-935-5508
Practice Address - Fax:201-935-4166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2010-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ950818OtherMEDICARE GROUP ID