FAIRLAWN BEHAVIORAL ASSOCIATES LLC (NPI# 1861876419) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861876419 |
| Entity Type | Organization |
| Organization Name | FAIRLAWN BEHAVIORAL ASSOCIATES LLC |
| Practice Address |
15-01 Broadway Suite# 10b Fair Lawn NJ 07410-6003 |
| Mailing Address |
Po Box 809 Teaneck NJ 07666-0809 |
| Practice Telephone | 2013424004 |
| Practice Fax Number | 2013424008 |
| Mailing Telephone | 2013424004 |
| Mailing Fax Number | 2012437874 |
| Enumeration Date | 2015-07-14 |
| Last Update Date | 2015-07-14 |
| Authorized Official Name | MR. MOHSAN JAN (ADMINISTARTOR) |
| Authorized Official Telephone | 2012898455 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TP0016X |
Psychologist Specialization: Prescribing (Medical) |
25MA6506500 | NJ | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | 7492201 | 05 |
| Street Address |
15-01 BROADWAY SUITE# 10B |
| City | FAIR LAWN |
| State | NJ |
| Zip Code | 07410-6003 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205813391 | Ramesh C Gupta | Internal Medicine | 15-01 Broadway, Suite 28, Fair Lawn, NJ 07410-6003 | 2005-12-29 |
| 1649752221 | Emelita D Paragas | Physical Therapist | 15-01 Broadway, Suite 30a, Fair Lawn, NJ 07410 | 2018-08-30 |
| 1154869733 | Beena Patel | Physical Therapist | 15-01 Broadway, Suite 30a, Fair Lawn, NJ 07410 | 2017-02-03 |
| 1952773392 | Fairlawn Behavioral Associates | Social Worker | 15-01 Broadway, Suite 10b, Fair Lawn, NJ 07410-6003 | 2015-10-26 |
| 1720400476 | Donald H Kutner Do LLC | Anesthesiology | 15-01 Broadway, Suite 34, Fair Lawn, NJ 07410-6003 | 2014-01-15 |
| 1023350238 | Imedical Associates, LLC | Internal Medicine | 15-01 Broadway, Suite 32, Fair Lawn, NJ 07410-6003 | 2013-03-26 |
| 1205125655 | Sovereign Medical Group LLC | Internal Medicine | 15-01 Broadway, Suite 1 & 3, Fair Lawn, NJ 07410 | 2011-04-06 |
| 1922300326 | Ma Grace Espinas | Physical Therapist | 15-01 Broadway, Suite 30a, Fair Lawn, NJ 07410-6003 | 2010-11-17 |
| 1750607008 | Rachel Carrie Mandel | Dentist | 15-01 Broadway, Fair Lawn, NJ 07410-6003 | 2010-04-12 |
| 1407184914 | Barry Jansen PC | Podiatrist | 15-01 Broadway, Suite 11, Fair Lawn, NJ 07410-6003 | 2009-11-20 |
| Find all providers in the same location | ||||
| 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 | 103TP0016X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Prescribing (Medical) |
| Those licensed psychologists who have completed specialized, post-doctoral training in psychopharmacology, passed a national proficiency examination in psychopharmacology, and who are authorized by state statute to prescribe medications, in accordance with their state law and state licensing authority, for the evaluation, diagnosis, management and treatment of mental, nervous, emotional, behavioral, and related disorders. |
| Notes: Source: Louisiana Academy of Medical Psychologists Note: Some states issue licenses under Medical Psychologist. [1/1/2007: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578855755 | Saiz, M.d. LLC | Psychologist | 2000 Bergenline Ave, Union City, NJ 07087-3350 | 2011-05-06 |
| 1770721854 | Psychiatric Associates of North Jersey, Inc | Psychologist | 288 Leonard Pl, Paramus, NJ 07652-4517 | 2009-01-28 |
| 1891957379 | Marina Moshkovich | Psychologist | Njsp Third and Cass Street, Trenton, NJ 08625 | 2008-06-26 |
| 1912124892 | Jesse Mintz | Psychologist | 10 Auer Ct Ste D, East Brunswick, NJ 08816-5848 | 2007-04-20 |
| 1962628818 | Peter S Mueller, M.d.,p.a | Psychologist | 601 Ewing St # A, Suite B-3, Princeton, NJ 08540-2757 | 2007-04-18 |
| 1073904801 | Avicenna Medical Center | Psychologist | 129 Valley Rd, 2nd Floor, Montclair, NJ 07042-2331 | 2015-02-16 |
| 1902297344 | Princeton Psychiatric Centers, Pa | Psychologist | 256 Bunn Dr, Suite 6, Princeton, NJ 08540-2859 | 2015-02-06 |
| 1639514946 | Deborra M. Torres, Msn Pmhnp LLC | Psychologist | 5 N Main St, Suite A, Medford, NJ 08055-2439 | 2013-05-01 |
| 1851677033 | Valeo Behavioral Health, Inc. | Psychologist | 2911 Route 88, Suite E8, Point Pleasant Boro, NJ 08742-2871 | 2011-11-01 |
| 1285953976 | Pinnicle Behavioral Health, LLC | Psychologist | 2911 Route 88, Suite E8, Point Pleasant, NJ 08742-2871 | 2010-05-20 |
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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.