1043286735 NPI number — ORTHOPAEDIC INSTITUTE OF CENTRAL JERSEY

Table of content: (NPI 1043286735)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043286735 NPI number — ORTHOPAEDIC INSTITUTE OF CENTRAL JERSEY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ORTHOPAEDIC INSTITUTE OF CENTRAL JERSEY
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1043286735
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2315 ROUTE 34 SOUTH
Provider Second Line Business Mailing Address:
SUITE D
Provider Business Mailing Address City Name:
MANASQUAN
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08736-1423
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
732-974-0404
Provider Business Mailing Address Fax Number:
732-974-3180

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2315 RT 34 SO.
Provider Second Line Business Practice Location Address:
SUITE D
Provider Business Practice Location Address City Name:
MANASQUAN
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08736-1423
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
732-974-0404
Provider Business Practice Location Address Fax Number:
732-974-3180
Provider Enumeration Date:
02/23/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MELESKY
Authorized Official First Name:
TERRY
Authorized Official Middle Name:
Authorized Official Title or Position:
ASSISTANT PRACTICE MANAGER
Authorized Official Telephone Number:
732-974-0404

Provider Taxonomy Codes

  • Taxonomy code: 207X00000X , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: C30811 . This is a "RAILROAD" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com