Organization
FAIRVIEW MEDICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS COLLEEN DOUGHERTY (BILLING)
(201) 263-1047
Entity
Organization
Contact information
Practice address
43 FAIRVIEW AVE, VERONA, NJ 07044
(201) 263-1047
Mailing address
43 FAIRVIEW AVE, VERONA, NJ 07044
(201) 263-1047
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MB06569500
NJ
Other
Enumeration date
07/07/2006
Last updated
03/27/2008
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