1679752166 NPI number — ORTHOPAEDIC ASSOCIATES PA

Table of content: (NPI 1679752166)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679752166 NPI number — ORTHOPAEDIC ASSOCIATES PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ORTHOPAEDIC ASSOCIATES 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:
COHEN, BERGER, GREENBLUM ASSOCIATES, PA
Provider Other Organization Name Type Code:
4
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:
1679752166
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:
PO BOX 973
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FAIR LAWN
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07410-0973
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
201-794-6008
Provider Business Mailing Address Fax Number:
201-794-6190

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1035 ROUTE 46 STE G2
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CLIFTON
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07013-2430
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
201-794-6008
Provider Business Practice Location Address Fax Number:
201-794-6190
Provider Enumeration Date:
10/31/2007

Additional Information

Authorized Official

Authorized Official Last Name:
GREENBLUM
Authorized Official First Name:
ROBERT
Authorized Official Middle Name:
Authorized Official Title or Position:
PHYSICIAN
Authorized Official Telephone Number:
201-794-6008

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , 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)





Copyright © 2007-2024 www.npivalidator.com