Coleman Addiction Medicine, P.C.

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

COLEMAN ADDICTION MEDICINE, P.C.

Practice address

23-00 State RT 208 Ste 1-1
Fair Lawn, NJ 07410-1558

Phone

(617) 996-8365

NPI assigned

Jun 19, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Genco D'Andria

Title

Cfo

Phone

(214) 379-3300

Specialties & licenses 2

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1560902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610496000000",
    "number": "1295395408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1720 LAKEPOINTE DR STE 117",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750576425",
            "telephone_number": "214-379-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23-00 STATE RT 208 STE 1-1",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074101558",
            "telephone_number": "617-996-8365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLEMAN ADDICTION MEDICINE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-19",
        "last_updated": "2021-01-13",
        "certification_date": "2021-01-13",
        "status": "A",
        "authorized_official_last_name": "D'ANDRIA",
        "authorized_official_first_name": "GENCO",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "214-379-3300"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Alan Cohen, DC
• Michael J Cohen, D.C.
• Randy Edward Cohen, MD
• Matthew R Coiro, PHARMD
• Frank E. Colabella, DPM, MS
• Kristen Colleran, M.V.B.
• John Collins
• Solimar Victoria Colon, PA
• Comfort Plus Inc
• Patricia Comly, LCSW

• Substance Use Disorder Rehabilitation Clinic/Center in Fair Lawn, NJ
• Providers in Fair Lawn, NJ by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.