Provider Demographics
NPI:1538038716
Name:ADVANCED PHYSICAL MEDICINE CENTER OF FAIRVIEW, LLC
Entity type:Organization
Organization Name:ADVANCED PHYSICAL MEDICINE CENTER OF FAIRVIEW, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:BERK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:201-945-1156
Mailing Address - Street 1:222 BERGEN BLVD STE 8
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW
Mailing Address - State:NJ
Mailing Address - Zip Code:07022-1300
Mailing Address - Country:US
Mailing Address - Phone:201-945-1156
Mailing Address - Fax:201-945-0012
Practice Address - Street 1:222 BERGEN BLVD STE 8
Practice Address - Street 2:
Practice Address - City:FAIRVIEW
Practice Address - State:NJ
Practice Address - Zip Code:07022-1300
Practice Address - Country:US
Practice Address - Phone:201-945-1156
Practice Address - Fax:201-945-0012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-04
Last Update Date:2025-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty