Metro Oba Medical Services PC

Primary specialty

SpecialistTaxonomy code 174400000X

License

206251 Issued in NY

Legal business name

METRO OBA MEDICAL SERVICES PC

Practice address

15 01 Pollitt Drive
Unite 8B
Fairlawn, NJ 07410

Phone

(845) 790-2672

NPI assigned

Nov 1, 2013

Organization subpart

No

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

Authorized official

Name

Carol Formisano

Title

Manager

Phone

(845) 790-2672

Specialties & licenses 1

Addresses

Practitioners 1

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

• Marshall Garland, M.D.

  • Anesthesiology Physician
  • New York, NY
  • NPI 1649272196
  NPD (past)

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

{
    "created_epoch": "1383264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383264000000",
    "number": "1902235872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 CATHARINE STREET",
            "address_2": "PO BOX 550",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126020550",
            "telephone_number": "845-790-2672",
            "fax_number": "845-790-2613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 01 POLLITT DRIVE",
            "address_2": "UNITE 8B",
            "city": "FAIRLAWN",
            "state": "NJ",
            "postal_code": "07410",
            "telephone_number": "845-790-2672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METRO OBA MEDICAL SERVICES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-01",
        "last_updated": "2013-11-01",
        "status": "A",
        "authorized_official_last_name": "FORMISANO",
        "authorized_official_first_name": "CAROL",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "845-790-2672"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "206251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Fairlawn, NJ
• Providers in Fairlawn, NJ by specialty
• Specialist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2013; 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.