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General NPI Number Information
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NPI Number | 1235121856
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Entity Type | Organization
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Legal Business Name | NORTH JERSEY EAR NOSE & THROAT
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Dates
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Enumeration Date | 08/19/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 36 NEWARK AVE SUITE 318
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City | BELLEVILLE
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State | NJ
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Zip | 07109-4119
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Country | US
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Telephone | 973-751-2251
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Fax | 973-751-4445
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Provider Business Mailing Address
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Address Line | 36 NEWARK AVE SUITE 318
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City | BELLEVILLE
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State | NJ
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Zip | 07109-4119
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Country | US
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Telephone | 973-751-2251
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Fax | 973-751-4445
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Authorized Official
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Title or Position | DOCTOR
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Name | ADEL BASILY SORIAL
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Credential | MD FACS
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Telephone | 973-751-2251
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | MA24432
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License Number State | NJ
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