NPIMap

Organization Active NPI

Osteopathic Medical Care Center

  • Primary Care Clinic/Center
  • Fair Lawn, NJ
National Provider Identifier
1730363250
Registry record updated Dec 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
25MB06860100 Issued in NJ
Legal business name
OSTEOPATHIC MEDICAL CARE CENTER
Practice address
39-40 Broadway
Fair Lawn, NJ 07410-5419
Phone
(201) 475-5006
Fax
(201) 475-5009
NPI assigned
Dec 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2007

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

Authorized official

Name
Aleksandr MartirosovNPI 1700931185
Title
DO
Phone
(201) 475-5006

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 25MB06860100 NJ Primary

Addresses

Primary practice location

39-40 Broadway
Fair Lawn, NJ 07410-5419

Mailing address

39-40 Broadway
Fair Lawn, NJ 07410-5419
Phone (201) 475-5006

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1198022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198022400000",
    "number": "1730363250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39-40 BROADWAY",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074105419",
            "telephone_number": "201-475-5006",
            "fax_number": "201-475-5009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39-40 BROADWAY",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074105419",
            "telephone_number": "201-475-5006",
            "fax_number": "201-475-5009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OSTEOPATHIC MEDICAL CARE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-19",
        "last_updated": "2007-12-19",
        "status": "A",
        "authorized_official_last_name": "MARTIROSOV",
        "authorized_official_first_name": "ALEKSANDR",
        "authorized_official_title_or_position": "DO",
        "authorized_official_telephone_number": "201-475-5006"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NJ",
            "license": "25MB06860100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fair Lawn, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 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.