Provider Demographics
NPI:1952099905
Name:FASTMED GROUP LLC
Entity Type:Organization
Organization Name:FASTMED GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARDS
Authorized Official - Middle Name:
Authorized Official - Last Name:AFONJA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-356-2284
Mailing Address - Street 1:7511 BERGENLINE AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH BERGEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07047-5459
Mailing Address - Country:US
Mailing Address - Phone:201-351-1630
Mailing Address - Fax:
Practice Address - Street 1:7511 BERGENLINE AVE
Practice Address - Street 2:
Practice Address - City:NORTH BERGEN
Practice Address - State:NJ
Practice Address - Zip Code:07047-5459
Practice Address - Country:US
Practice Address - Phone:201-351-1630
Practice Address - Fax:201-246-6200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-27
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical OncologyGroup - Multi-Specialty