1063778140 NPI number — ORTHOPEDIC ASSOCIATES OF CENTRAL JERSEY PA

Table of content: (NPI 1063778140)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1063778140 NPI number — ORTHOPEDIC ASSOCIATES OF CENTRAL JERSEY PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ORTHOPEDIC ASSOCIATES OF CENTRAL JERSEY PA
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:
1063778140
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/03/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
205 MAY ST.
Provider Second Line Business Mailing Address:
SUITE 202
Provider Business Mailing Address City Name:
EDISON
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08837-3267
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
908-757-1520
Provider Business Mailing Address Fax Number:
908-769-1388

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3 HOSPITAL PLAZA
Provider Second Line Business Practice Location Address:
SUITE 411
Provider Business Practice Location Address City Name:
OLD BRIDGE
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08857-2190
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
732-360-2400
Provider Business Practice Location Address Fax Number:
732-360-2030
Provider Enumeration Date:
04/03/2012

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MCDONALD
Authorized Official First Name:
CATHERINE
Authorized Official Middle Name:
A
Authorized Official Title or Position:
OFFICE MANAGER
Authorized Official Telephone Number:
908-757-1520

Provider Taxonomy Codes

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

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