Fresenius Medical Care Comprehensive CKD SE

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

Legal business name

FRESENIUS MEDICAL CARE COMPREHENSIVE CKD SE

Doing business as

CKD Services of New Jersey

Practice address

83 Hanover Rd.
Suite 290
Florham Park, NJ 07932-1508

Phone

(973) 966-5200

Fax

(973) 966-0300

NPI assigned

Mar 25, 2008

Organization subpart

Yes

Parent organization

FRESENIUS MEDICAL CARE HOLDINGS, INC.As reported in NPPES

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

Authorized official

Name

Mr. Mark R Fawcett

Title

Vice President, Treasurer

Phone

(781) 699-2668

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• CKD Services of New Jersey Doing business as

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

{
    "created_epoch": "1206403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297036800000",
    "number": "1730351289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 WINTER ST",
            "address_2": "FMCNA CKD SERVICES 3W-16",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024511521",
            "telephone_number": "781-699-4160",
            "fax_number": "781-699-4046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "83 HANOVER RD.",
            "address_2": "SUITE 290",
            "city": "FLORHAM PARK",
            "state": "NJ",
            "postal_code": "079321508",
            "telephone_number": "973-966-5200",
            "fax_number": "973-966-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRESENIUS MEDICAL CARE COMPREHENSIVE CKD SE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FRESENIUS MEDICAL CARE HOLDINGS, INC.",
        "enumeration_date": "2008-03-25",
        "last_updated": "2011-02-07",
        "status": "A",
        "authorized_official_last_name": "FAWCETT",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "VICE PRESIDENT, TREASURER",
        "authorized_official_telephone_number": "781-699-2668",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0189723",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CKD Services of New Jersey",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Bryan Franciosi, PT, DPT, ATC
• Joel Grancell Frank, DO
• Renee Ellen Frankel, MD
• Isabella Freda, LAC
• Robert Saul Freid, MD
• Molly Fried, LCSW
• Jessica Marie Friedhoff, LSW
• Jerrold Fruchtman, O.D.
• Kennedy Ogbazion Gabre, M.D.
• Lilibeth Dy Gaerlan, P.T.

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Florham Park, NJ
• Providers in Florham Park, NJ by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2011; 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.