Fair Lawn ASC LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

FAIR LAWN ASC LLC

Practice address

15-01 Pollitt Dr
Fair Lawn, NJ 07410-2769

Phone

(516) 433-4447

Fax

(516) 433-4447

NPI assigned

Mar 19, 2010

Last updated

Mar 19, 2010By 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

Dr. Marshall Garland, M.D.NPI 1649272196

Title

Medical Director

Phone

(516) 433-4447

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Listed as

Fair Lawn ASC LLCCCN 31C0001266

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Marshall Garland, M.D.

  • Anesthesiology Physician
  • New York, NY
  • NPI 1649272196
  NPD (past) Authorized official
• Jonathan Campos

  • Psychiatric/Mental Health Nurse Practitioner
  • Park Ridge, NJ
  • NPI 1356221725
  NPD (past)

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

{
    "created_epoch": "1268956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268956800000",
    "number": "1679897623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15-01 POLLITT DR",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074102769",
            "telephone_number": "516-433-4447",
            "fax_number": "516-433-4447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15-01 POLLITT DR",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074102769",
            "telephone_number": "516-433-4447",
            "fax_number": "516-433-4447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIR LAWN ASC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-19",
        "last_updated": "2010-03-19",
        "status": "A",
        "authorized_official_last_name": "GARLAND",
        "authorized_official_first_name": "MARSHALL",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "516-433-4447",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Marie Ettore, OTR/L
• Tiffany Evangelou
• Everside Health-Fair Lawn Health Center (Marathon Health, Fair Lawn NJ)
• Fair Lawn Advanced Footcare PC
• Fair Lawn Anesthesia Associates, LLC
• Fair Lawn Behavioral Health, LLC
• Fair Lawn Chiropractic Clinic PA
• Fair Lawn Chiropractic Therapy LLC
• Fair Lawn Diagnostics LLC
• Fair Lawn Foot and Ankle Associates PC

• Ambulatory Surgical Clinic/Center in Fair Lawn, NJ
• Providers in Fair Lawn, NJ by specialty
• Ambulatory Surgical Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.