Provider Demographics
NPI:1942215306
Name:TOLIVER, CLIFFORD W (MD)
Entity Type:Individual
Prefix:DR
First Name:CLIFFORD
Middle Name:W
Last Name:TOLIVER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:310 CENTRAL AVE
Mailing Address - Street 2:STE 201
Mailing Address - City:EAST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07018-2835
Mailing Address - Country:US
Mailing Address - Phone:973-676-6207
Mailing Address - Fax:973-676-3974
Practice Address - Street 1:310 CENTRAL AVE
Practice Address - Street 2:STE 201
Practice Address - City:EAST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07018-2835
Practice Address - Country:US
Practice Address - Phone:973-676-6207
Practice Address - Fax:973-676-3974
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2013-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA33187207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJF13666OtherHEATH NET OF NE
NJGHIOtherGHI
NJ5Y3431OtherEMPIRE BLUE SHIELD
NJ3076202Medicaid
NJP430048OtherOXFORD
NJ0494696OtherAETNA
NJ1035108OtherHORIZON NJ HEALTH
NJ7958501Medicaid
NJ16560OtherAMERIGROUP
NJ1601581OtherUNITED HEALTHCARE
NJC56277Medicare UPIN
NJ1601581OtherUNITED HEALTHCARE
NJ7958501Medicaid