Healthcare Provider Details

I. General information

NPI: 1558347351
Provider Name (Legal Business Name): EAR, NOSE, THROAT AND FACIAL PLASTIC SURGEONS, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51 RT 23 SOUTH FLOOR 2
RIVERDALE NJ
07457
US

IV. Provider business mailing address

51 RT 23 SOUTH FLOOR 2
RIVERDALE NJ
07457
US

V. Phone/Fax

Practice location:
  • Phone: 973-831-1220
  • Fax: 973-831-0029
Mailing address:
  • Phone: 973-831-1220
  • Fax: 973-831-0029

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YS0123X
TaxonomyFacial Plastic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. HOWARD TAYLOR
Title or Position: PRESIDENT
Credential: M.D.
Phone: 973-831-1220