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NORTHEAST REGIONAL CENTER FOR ORAL & MAXILLOFACIAL SURGERY NPI 1164806972


NPI Information

NPI: 1164806972
Provider Name: NORTHEAST REGIONAL CENTER FOR ORAL & MAXILLOFACIAL SURGERY
Classification: Dentist - 1223S0112X
Entity Type: Organization

Specialization: Oral and Maxillofacial Surgery

CLIA Number: 31D2209039

Address:
50 E MAIN ST
LITTLE FALLS, NJ
ZIP 07424
Phone: (973) 256-0103
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NORTHEAST REGIONAL CENTER FOR ORAL & MAXILLOFACIAL SURGERY is an oral and maxillofacial surgery dentist in Little Falls, NJ. The provider is an oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. NORTHEAST REGIONAL CENTER FOR ORAL & MAXILLOFACIAL SURGERY NPI is 1164806972. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

50 E MAIN ST
LITTLE FALLS, NJ
ZIP 07424-604
Phone: (973) 256-0103
Fax: (973) 256-8066

The provider's authorized official is Richard Patrick Szumita .
The authorized official title is Owner and has the following contact phone number (973) 256-0103.

The CLIA number assigned to this NPI record is 31D2209039 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/13/2015 and was last updated on 7/13/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223S0112XDentistOral and Maxillofacial SurgeryDI18430NEW JERSEYYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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