Provider Demographics
NPI:1558347351
Name:EAR, NOSE, THROAT AND FACIAL PLASTIC SURGEONS, P.A.
Entity Type:Organization
Organization Name:EAR, NOSE, THROAT AND FACIAL PLASTIC SURGEONS, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-831-1220
Mailing Address - Street 1:51 RT 23 SOUTH
Mailing Address - Street 2:FLOOR 2
Mailing Address - City:RIVERDALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07457
Mailing Address - Country:US
Mailing Address - Phone:973-831-1220
Mailing Address - Fax:973-831-0029
Practice Address - Street 1:51 RT 23 SOUTH
Practice Address - Street 2:FLOOR 2
Practice Address - City:RIVERDALE
Practice Address - State:NJ
Practice Address - Zip Code:07457
Practice Address - Country:US
Practice Address - Phone:973-831-1220
Practice Address - Fax:973-831-0029
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJG73467Medicare UPIN
NJD19722Medicare UPIN
NJI33539Medicare UPIN
NJC59830Medicare UPIN
NJRE191452Medicare ID - Type Unspecified
NJ011215Medicare ID - Type Unspecified
NJ092375Medicare ID - Type Unspecified
NJ024816Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER
NJTA461025Medicare ID - Type Unspecified