BERGENLINE FAMILY MEDICINE
NPI 1811207475
Clinic/Center - Primary Care in West New York, NJ
About Bergenline Family Medicine NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
BERGENLINE FAMILY MEDICINE (NPI 1811207475) is a healthcare organization registered as a primary care in West New York, New Jersey and active in the NPI registry since October 2010. The organization holds a CLIA Waiver certificate valid through April 11, 2027 and lists Gil V. Fajardo, Director, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 3
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 31D0985267
Bergenline Family Medicine LLC · West New York, NJOther Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Bergenline Family Medicine's NPI number?
The NPI number for Bergenline Family Medicine is 1811207475. It was assigned to this organization in the NPPES registry on October 18, 2010.
Where is Bergenline Family Medicine located?
Bergenline Family Medicine is located at 333 60th St, West New York, NJ 07093. The listed phone number is (201) 453-8777.
What is Bergenline Family Medicine's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.
Does Bergenline Family Medicine hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 31D0985267) is associated with this NPI, valid through April 11, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Bergenline Family Medicine was last updated on January 4, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Bergenline Family Medicine · NPI 1811207475
Primary Care organization in West New York, New Jersey. Organization record, active in the CMS NPPES registry since October 18, 2010.
## Identity
- **NPI:** 1811207475 (Entity type: Organization)
- **Enumerated:** October 18, 2010
- **Primary specialty:** Clinic/Center - Primary Care · taxonomy 261QP2300X
- **Organization subpart:** No
- **Authorized official:** Gil Fajardo, DIRECTOR
## Practice location
- **Address:** 333 60TH ST, West New York, NJ 07093-5487
- **Phone:** (201) 453-8777 · **Fax:** (201) 453-8804
## Record status
- **NPPES last updated:** January 4, 2011
- **Other identifiers:** Other G37823 (NJ); Medicare PIN 893377 (NJ); Medicaid 7003803 (NJ)
- **CLIA laboratory certificates:** 1 on file
---
Source: [NPI Profile](https://npiprofile.com/npi/1811207475) · Data from the CMS NPPES public registry.