Borough of Fort Lee

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

BOROUGH OF FORT LEE

Practice address

309 Main St
Fort Lee, NJ 07024-4705

Phone

(201) 347-2114

NPI assigned

Nov 5, 2008

Last updated

Dec 7, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Paul Favia, EMT

Title

EMS Director

Phone

(201) 592-3637

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

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

{
    "created_epoch": "1225843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701907200000",
    "number": "1528212537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 E TAUNTON RD STE 500",
            "city": "BERLIN",
            "state": "NJ",
            "postal_code": "080092615",
            "telephone_number": "866-476-1702",
            "fax_number": "609-481-2270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 MAIN ST",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070244705",
            "telephone_number": "201-347-2114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOROUGH OF FORT LEE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-05",
        "last_updated": "2023-12-07",
        "certification_date": "2023-12-07",
        "status": "A",
        "authorized_official_last_name": "FAVIA",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "EMS DIRECTOR",
        "authorized_official_telephone_number": "201-592-3637",
        "authorized_official_credential": "EMT"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0223859",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Board Certified Orthopedic Surgical Specilists LLC
• Svetlana Bodneva, D.D.S.,
• Candace Ann Boltuch-Fagan, LPC;LCADC
• Anup Borawala
• Boris Mordkovich MD Plastic Surgery, PC
• Borough of Fort Lee
• Michelle L Botsacos, OD
• Juanita Latrelle Boyd
• Dinah Joan Braude Kremberg, PHD
• Judith S Brauner, LCSW

• Land Ambulance in Fort Lee, NJ
• Providers in Fort Lee, NJ by specialty
• Land Ambulance in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.