Emilya Fardman, M.D.

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

MA07182 Issued in NJ

Practice address

300 2ND Ave
Long Branch, NJ 07740-6303

Phone

(732) 923-6900

Fax

(732) 923-6914

NPI assigned

Nov 10, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497826630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15378",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071925378",
            "telephone_number": "732-923-6900",
            "fax_number": "732-923-6914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 2ND AVE",
            "city": "LONG BRANCH",
            "state": "NJ",
            "postal_code": "077406303",
            "telephone_number": "732-923-6900",
            "fax_number": "732-923-6914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARDMAN",
        "first_name": "EMILYA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NJ",
            "license": "MA07182",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8682607",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Child & Adolescent Psychiatry Physician in Long Branch, NJ
• Providers in Long Branch, NJ by specialty
• Child & Adolescent Psychiatry Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.