Fairview Medical

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MB06569500 Issued in NJ

Legal business name

FAIRVIEW MEDICAL

Practice address

43 Fairview Ave
Verona, NJ 07044

Phone

(201) 263-1047

NPI assigned

Jul 7, 2006

Organization subpart

No

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

Authorized official

Name

Miss Colleen Dougherty

Title

Billing

Phone

(201) 263-1047

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206576000000",
    "number": "1437181773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 FAIRVIEW AVE",
            "city": "VERONA",
            "state": "NJ",
            "postal_code": "07044",
            "telephone_number": "201-263-1047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43 FAIRVIEW AVE",
            "city": "VERONA",
            "state": "NJ",
            "postal_code": "07044",
            "telephone_number": "201-263-1047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRVIEW MEDICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2008-03-27",
        "status": "A",
        "authorized_official_last_name": "DOUGHERTY",
        "authorized_official_first_name": "COLLEEN",
        "authorized_official_title_or_position": "BILLING",
        "authorized_official_telephone_number": "201-263-1047",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "MB06569500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan A. Duffy, ED.S.
• Patrick Timothy Pace Duggan, MD
• Edmund S. Liu, MD, PA
• Envision Center
• Melissa Ann Eppinger, MD
• Donna Lynn Fellenberg, MSW
• John Craig Fenkart, PT, DPT
• Jaclyn Festa, M.A., L.P.C., A.T.R.
• Erin Field, LPC
• First Care Medical Group Inc

• Internal Medicine Physician in Verona, NJ
• Providers in Verona, NJ by specialty
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2008; 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.