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ESCALES MEDICAL ASSOCIATES AT WAYNE LLC
Complete NPI Record 1780153338
Clinic/Center - Multi-Specialty in Wayne, NJ

NPI Status: Active since November 13, 2018

Contact Information

342 HAMBURG TPKE STE 101
WAYNE, NJ
ZIP 07470
Phone: (973) 942-4140
Fax: (973) 942-5070

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Table of Contents

  1. NPI
  2. Entity Type Code
  3. Employer Identification Number EIN
  4. Provider Organization Name Legal Business Name
  5. Provider First Line Business Mailing Address
  6. Provider Business Mailing Address City Name
  7. Provider Business Mailing Address State Name
  8. Provider Business Mailing Address Postal Code
  9. Provider Business Mailing Address Country Code If outside U S
  10. Provider Business Mailing Address Telephone Number
  11. Provider First Line Business Practice Location Address
  12. Provider Business Practice Location Address City Name
  13. Provider Business Practice Location Address State Name
  14. Provider Business Practice Location Address Postal Code
  15. Provider Business Practice Location Address Country Code If outside U S
  16. Provider Business Practice Location Address Telephone Number
  17. Provider Business Practice Location Address Fax Number
  18. Provider Enumeration Date
  19. Last Update Date
  20. Authorized Official Last Name
  21. Authorized Official First Name
  22. Authorized Official Middle Name
  23. Authorized Official Title or Position
  24. Authorized Official Telephone Number
  25. Healthcare Provider Taxonomy Code 1
  26. Healthcare Provider Primary Taxonomy Switch 1
  27. Other Provider Identifier 1
  28. Other Provider Identifier Type Code 1
  29. Other Provider Identifier State 1
  30. Other Provider Identifier Issuer 1
  31. Other Provider Identifier 2
  32. Other Provider Identifier Type Code 2
  33. Other Provider Identifier State 2
  34. Other Provider Identifier Issuer 2
  35. Other Provider Identifier 3
  36. Other Provider Identifier Type Code 3
  37. Other Provider Identifier State 3
  38. Other Provider Identifier Issuer 3
  39. Other Provider Identifier 4
  40. Other Provider Identifier Type Code 4
  41. Other Provider Identifier State 4
  42. Other Provider Identifier Issuer 4
  43. Other Provider Identifier 5
  44. Other Provider Identifier Type Code 5
  45. Other Provider Identifier State 5
  46. Other Provider Identifier Issuer 5
  47. Other Provider Identifier 6
  48. Other Provider Identifier Type Code 6
  49. Other Provider Identifier State 6
  50. Other Provider Identifier Issuer 6
  51. Other Provider Identifier 7
  52. Other Provider Identifier Type Code 7
  53. Other Provider Identifier State 7
  54. Other Provider Identifier Issuer 7
  55. Other Provider Identifier 8
  56. Other Provider Identifier Type Code 8
  57. Other Provider Identifier State 8
  58. Other Provider Identifier Issuer 8
  59. Other Provider Identifier 9
  60. Other Provider Identifier Type Code 9
  61. Other Provider Identifier State 9
  62. Other Provider Identifier Issuer 9
  63. Is Organization Subpart
  64. Authorized Official Name Prefix Text
  65. Authorized Official Credential Text
  66. NPI Certification Date

Complete NPI Dataset

This page represents the complete record for NPI 1780153338. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1780153338
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code: 2
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Employer Identification Number EIN: UNAVAIL
The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
The name of the organization provider. If the provider is an organization, this is the legal business name.
Provider First Line Business Mailing Address: 342 HAMBURG TPKE STE 101
The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Business Mailing Address City Name: WAYNE
The city name in the mailing address of the provider being identified.
Provider Business Mailing Address State Name: NJ
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Mailing Address Postal Code: 074702166
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Provider Business Mailing Address Country Code If outside U S : US
The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider Business Mailing Address Telephone Number: 9737153475
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Provider First Line Business Practice Location Address: 342 HAMBURG TPKE STE 101
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name: WAYNE
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name: NJ
The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code: 074702166
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S : US
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 9739424140
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number: 9739425070
The fax number associated with the location address of the provider being identified.
Provider Enumeration Date: 11/13/2018
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date: 4/5/2021
The date that a record was last updated or changed.
Authorized Official Last Name: WARDEH
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First Name: GHASSAN
The first name of the authorized official.
Authorized Official Middle Name: LOUIS
The middle name of the authorized official.
Authorized Official Title or Position: PCP/PULMONOLOGIST/SLEEP SPECIALIST
The title or position of the authorized official.
Authorized Official Telephone Number: 9739424140
The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code 1: 261QM1300X
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Healthcare Provider Primary Taxonomy Switch 1: Y
Other Provider Identifier 1: P616-3453
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 1: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 1: NJ
Other Provider Identifier Issuer 1: OXFORD
Other Provider Identifier 2: 1997788
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 2: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 2: NJ
Other Provider Identifier Issuer 2: WELLCARE
Other Provider Identifier 3: 60420852
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 3: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 3: NJ
Other Provider Identifier Issuer 3: HORIZON NJ HEALTH
Other Provider Identifier 4: 758490
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 4: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 4: NJ
Other Provider Identifier Issuer 4: MEDICARE
Other Provider Identifier 5: PBS004295675
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 5: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 5: NJ
Other Provider Identifier Issuer 5: AMERIHEALTH
Other Provider Identifier 6: 07135891
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 6: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 6: NJ
Other Provider Identifier Issuer 6: AMERIGROUP
Other Provider Identifier 7: 00040117774
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 7: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 7: NJ
Other Provider Identifier Issuer 7: UHC
Other Provider Identifier 8: 6149915
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 8: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 8: NJ
Other Provider Identifier Issuer 8: AETNA
Other Provider Identifier 9: PBS4295675
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 9: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 9: NJ
Other Provider Identifier Issuer 9: AMERIHEALTH
Is Organization Subpart: N
Authorized Official Name Prefix Text: MISS
Authorized Official Credential Text: MD
NPI Certification Date: 4/5/2021