MARTIN KOENIGSBERG D.O. PA. (NPI# 1306009410) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306009410 |
| Entity Type | Organization |
| Organization Name | MARTIN KOENIGSBERG D.O. PA. |
| Practice Address |
19-03 Maple Ave Ste2 Fair Lawn NJ 07410-1553 |
| Mailing Address |
19-03 Maple Ave Suite 2 Fair Lawn NJ 07410-1553 |
| Practice Telephone | 9735565744 |
| Mailing Telephone | 9735565744 |
| Mailing Fax Number | 2018184863 |
| Enumeration Date | 2008-07-08 |
| Last Update Date | 2008-07-08 |
| Authorized Official Name | MARTIN A KOENIGSBERG (PRESIDENT) |
| Authorized Official Telephone | 9735565744 |
| Authorized Official Credential | D.O. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 25MB03362200 | NJ | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | 0061638 | 05 |
| Street Address |
19-03 MAPLE AVE STE2 |
| City | FAIR LAWN |
| State | NJ |
| Zip Code | 07410-1553 |
| 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 | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972016301 | Ashlen Michal Kakolewski | Family Medicine | 19-21 Fair Lawn Ave # 725, Fair Lawn, NJ 07410-2331 | 2017-11-07 |
| 1912250390 | Care Abc, PC | Family Medicine | 17-17 Broadway, Fair Lawn, NJ 07410-2055 | 2012-10-22 |
| 1003146994 | Marvin Wisch Pa | Family Medicine | 28-09 Fair Lawn Ave, Fair Lawn, NJ 07410-3410 | 2009-12-28 |
| 1366604605 | Samia Riaz Chaudry | Family Medicine | 41 04 Goldblatt Terrace, Fair Lawn, NJ 07410-5911 | 2008-06-27 |
| 1770126278 | Cam P.C. | Family Medicine | 23-00 State Rt 208 Ste 1-1, Fair Lawn, NJ 07410-1558 | 2019-10-28 |
| 1295181584 | Balanced Well Medical Network | Family Medicine | 23-08 Maple Ave, Fair Lawn, NJ 07410-1583 | 2016-05-05 |
| 1568866127 | Nj Nyc Medical Rehab PC | Family Medicine | 23-08 Maple Ave, Fair Lawn, NJ 07410-1583 | 2014-10-10 |
| 1639514169 | Eirene George John | Family Medicine | 20-20 Fair Lawn Ave, Second Floor, Fair Lawn, NJ 07410-2300 | 2013-05-10 |
| 1922380856 | Samia R. Chaudry Do LLC | Family Medicine | 41-04 Goldblatt Ter, Fair Lawn, NJ 07410-5911 | 2011-09-16 |
| 1962712471 | Comprehensive Health Care of New Jersey,llc | Family Medicine | 22-18 Broadway, Fair Lawn, NJ 07410-3016 | 2010-10-18 |
| 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.