Organization · NPI-2

01 Medical Group LLC

Psychiatry & Neurology, Addiction Medicine · Fair Lawn, NJ

NPI number1831595776

StatusActive

Last updated in NPPESNov 4, 2014

Details

NPI: 1831595776
Entity type: Organization (NPI-2)
Legal business name: 01 Medical Group LLC
Organization subpart: No
Enumeration date: Nov 4, 2014
Last updated: Nov 4, 2014

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
2084A0401X	Psychiatry & Neurology, Addiction Medicine	–	–	Yes

Practice location

16-01 Broadway
Fair Lawn, NJ 07410-2026

Phone 888-443-3869

Mailing address

2328 10th Ave N Fl 3
Lake Worth, FL 33461-6606

Phone 888-443-3869

Authorized official

James Stokes Aitken
Chief Operating Officer
5613184411

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