Healthcare Provider Details

I. General information

NPI: 1053202523
Provider Name (Legal Business Name): FAIRVIEW CARE CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2025
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 FAIRVIEW PL
BROOKLYN NY
11226-4216
US

IV. Provider business mailing address

12 FAIRVIEW PL
BROOKLYN NY
11226-4216
US

V. Phone/Fax

Practice location:
  • Phone: 718-587-0253
  • Fax: 718-587-0956
Mailing address:
  • Phone: 718-587-0253
  • Fax: 718-587-0956

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: GERSHON MARTON
Title or Position: ADMINISTRATOR
Credential:
Phone: 347-855-4977