DR. ROMAN N KOSIBOROD (NPI# 1831192079) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831192079 |
| Entity Type | Individual |
| Full Name | DR. ROMAN N KOSIBOROD |
| Credential | D.O. |
| Practice Address |
39-40 Broadway Ste 1 Fair Lawn NJ 07410 |
| Mailing Address |
387 Vance Ave Franklin Lakes NJ 07417-3016 |
| Practice Telephone | 2015098998 |
| Practice Fax Number | 9732467120 |
| Mailing Telephone | 2019824706 |
| Mailing Fax Number | 9732467120 |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2019-04-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 25MB07566200 | NJ | Other Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 429 Crestwood Ave, Hackensack, NJ 076011444 | 2013425057 |
| Street Address |
39-40 BROADWAY STE 1 |
| City | FAIR LAWN |
| State | NJ |
| Zip Code | 07410 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922422237 | Alliance Spine Associates LLC | Anesthesiology | 39-40 Broadway Ste 1, Fair Lawn, NJ 07410-5413 | 2014-02-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669093316 | Sheila Robinson-kiss LLC | Counselor | 0-178 Tunbridge Road, Fair Lawn, NJ 07410 | 2020-05-05 |
| 1750902813 | Pine Group LLC | Point of Service | 0-39 Pine Ave, Fair Lawn, NJ 07410 | 2020-04-29 |
| 1073133153 | Maria Jidriska Myers | Nurse Practitioner | 23-00 Nj-208, Fair Lawn, NJ 07410 | 2020-04-20 |
| 1508350869 | Jill Marie Deperi | Counselor | 22-08 Route 208 South, Fair Lawn, NJ 07410 | 2018-06-20 |
| 1952895419 | Laurel Olson | Counselor | Care Plus Nj Children and Family Services, 17-07 Romaine Street, Fair Lawn, NJ 07410 | 2018-06-19 |
| 1851896583 | Janelle Frazier | Social Worker | Care Plus New Jersey, 17-07 Romaine St, Fair Lawn, NJ 07410 | 2018-03-26 |
| 1457876260 | Daniella Suric | Behavioral Analyst | 2-08 Morlot Avenue, Fair Lawn, NJ 07410 | 2017-08-14 |
| 1912453549 | Marcia Gurfield | Social Worker | 33-03 Ryan Road, Fair Lawn, NJ 07410 | 2016-09-01 |
| 1417330721 | The Arc of Bergen and Passaic Counties, Inc | Day Training, Developmentally Disabled Services | 17-03a Broadway, Fair Lawn, NJ 07410 | 2015-07-06 |
| 1275914228 | Julius Iratagotia | Occupational Therapist | 0-53 26th St, Fair Lawn, NJ 07410 | 2015-06-16 |
| Find all providers in zip 07410 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073992905 | Errol Seltzer | Specialist | 39-23 Dauria Dr, Fair Lawn, NJ 07410-5143 | 2015-05-26 |
| 1639431174 | Bella Morrow | Specialist | 13-05 Saint Anne St, Fair Lawn, NJ 07410-2035 | 2012-06-11 |
| 1679870083 | Mike Miron, M.d.,p.c. | Specialist | 40-04 Kilada Ct, Fair Lawn, NJ 07410-5342 | 2011-02-21 |
| 1861717324 | Alisha C Romano | Specialist | 31-10 Nicholson Dr, Fair Lawn, NJ 07410-4145 | 2010-03-28 |
| 1407972755 | Clinical Psychiatry Consultants PC | Specialist | 13-14 6th St, Fair Lawn, NJ 07410-1119 | 2007-03-21 |
| 1851472690 | Steven I. Becker | Specialist | 33-00 Broadway Ste 204, Fair Lawn, NJ 07410-4603 | 2006-10-18 |
| 1053421032 | Merab Joseph | Specialist | 24-07 Broadway, Fair Lawn, NJ 07410-3053 | 2006-08-30 |
| 1053344077 | Ramin Barry Cocoziello | Specialist | 12-15 Broadway, Suite E, Fair Lawn, NJ 07410-2031 | 2006-07-10 |
| 1578596540 | Neurology Pain Treatment, P.C. | Specialist | 24-20 Broadway, Fair Lawn, NJ 07410-3057 | 2006-07-10 |
| 1356399943 | Rinko Orthopedic Appliances, Inc. | Specialist | 25-09 Broadway, Fair Lawn, NJ 07410-3813 | 2006-05-05 |
| Find all providers in FAIR LAWN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.