Bergenline Family Medicine

LBN: Bergenline Family Medicine
Bergenline Family Medicine is an health care organization with primary practice located at 333 60Th St , West New York NJ 07093-5487. The organization recently has only one registered license in Ambulatory Health Care Facilities / Primary Care, which is considered as the primary health care specialty. Bergenline Family Medicine can be contacted via phone (201) 453-8777, or through Fajardo, Gil V. via phone (201) 453-8777.

Contact Information

Primary practice address
333 60Th St West New York NJ 07093-5487
Phone: (201) 453-8777
Fax: (201) 453-8804
Website:
Map and Directions
Authorized official contact:
Name: Fajardo, Gil V. Doctor of Medicine (MD)
Phone: (201) 453-8777

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Primary Care 261QP2300X MA062055 New Jersey

Profile Details

NPI number 1811207475
LBN Legal business name Bergenline Family Medicine
DBA Doing business as
Authorized official Fajardo, Gil V. Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Oct 18th, 2010
Last updated Jan 4th, 2011 - about 15 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1811207475 NPPES
New Jersey Other G37823 UPIN
New Jersey MEDICAID 7003803 UPIN

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