01 MEDICAL GROUP LLC (NPI# 1831595776) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831595776 |
| Entity Type | Organization |
| Organization Name | 01 MEDICAL GROUP LLC |
| Practice Address |
16-01 Broadway Fair Lawn NJ 07410-2026 |
| Mailing Address |
2328 10th Ave N Fl 3 Lake Worth FL 33461-6606 |
| Practice Telephone | 8884433869 |
| Mailing Telephone | 8884433869 |
| Enumeration Date | 2014-11-04 |
| Last Update Date | 2014-11-04 |
| Authorized Official Name | JAMES STOKES AITKEN (CHIEF OPERATING OFFICER) |
| Authorized Official Telephone | 5613184411 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084A0401X |
Psychiatry & Neurology Specialization: Addiction Medicine |
Allopathic & Osteopathic Physicians |
| Street Address |
16-01 BROADWAY |
| City | FAIR LAWN |
| State | NJ |
| Zip Code | 07410-2026 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407276975 | Counseling Center At Fair Lawn, LLC | Clinic/Center | 16-01 Broadway, Fair Lawn, NJ 07410-2026 | 2014-04-23 |
| 1760039564 | Jordan Brown Sander | Social Worker | 16-01 Broadway, Fair Lawn, NJ 07410-2026 | 2019-08-26 |
| 1770130007 | Phoebe Elizabeth Sumas | Counselor | 16-01 Broadway, Fair Lawn, NJ 07410-2026 | 2019-08-21 |
| 1982251401 | Kristie Ashe | Social Worker | 16-01 Broadway, Fair Lawn, NJ 07410-2026 | 2019-08-20 |
| 1891340972 | Maria Medina | Social Worker | 16-01 Broadway, Fair Lawn, NJ 07410-2026 | 2019-08-06 |
| 1609421908 | Adam Daniel | Counselor | 16-01 Broadway, Fair Lawn, NJ 07410-2026 | 2019-08-05 |
| 1811372790 | Fair Lawn Diagnostics LLC | Clinical Medical Laboratory | 16-01 Broadway, Fair Lawn, NJ 07410-2026 | 2015-07-21 |
| 1073908018 | Mh At Fair Lawn LLC | Counselor | 16-01 Broadway, Fair Lawn, NJ 07410-2026 | 2015-04-06 |
| 1295131134 | Route 4 Medical Associates LLC | Clinical Medical Laboratory | 16-01 Broadway, Fair Lawn, NJ 07410-2026 | 2014-11-04 |
| 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 | 2084A0401X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Addiction Medicine |
| A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine |
| Notes: Source: American Osteopathic Board of Neurology and Psychiatry, 2007 [1/1/2008: definition added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720637150 | Caremed Plus P.C. | Psychiatry & Neurology | 508 Hamburg Tpke Ste 107, Wayne, NJ 07470-8482 | 2019-09-09 |
| 1003375023 | Center for Network Therapy | Psychiatry & Neurology | 20 Gibson Pl Ste 103, Freehold, NJ 07728-4837 | 2019-03-19 |
| 1548751258 | Garden State Treatment Center LLC | Psychiatry & Neurology | 350 Sparta Ave Ste A-201, Sparta, NJ 07871 | 2018-05-29 |
| 1295255149 | Bergen Psychiatric Care LLC | Psychiatry & Neurology | 65 N Maple Ave Ste 104, Ridgewood, NJ 07450-3233 | 2017-06-21 |
| 1255654752 | Tamer William Wassef | Psychiatry & Neurology | 424 Baldwin Ave, Jersey City, NJ 07306 | 2010-03-11 |
| 1861651077 | Jeffrey H Simon | Psychiatry & Neurology | 1930 Marlton Pike E Ste U100, Cherry Hill, NJ 08003-4212 | 2008-06-03 |
| 1730353814 | Joseph Glen Vitolo | Psychiatry & Neurology | 27 Hillsborough Dr, Monroe, NJ 08831-4746 | 2008-04-18 |
| 1992927859 | Todd Meredith Wilding | Psychiatry & Neurology | 7 Macculloch Ave., 2nd Floor, Morristown, NJ 07960 | 2007-05-02 |
| 1174648232 | Jacob H Jacoby | Psychiatry & Neurology | 654 Ave C, Suite 201, Bayonne, NJ 07002 | 2007-03-20 |
| 1265506158 | Cecilia Kalijman Karol | Psychiatry & Neurology | 1055 River Rd, Apt.511 S., Edgewater, NJ 07020-1364 | 2006-11-20 |
| Find all providers with the same taxonomy | ||||
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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.