1649444589 NPI number — ORTHOPAEDICS UNLIMITED LLC

Table of content: (NPI 1649444589)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649444589 NPI number — ORTHOPAEDICS UNLIMITED LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ORTHOPAEDICS UNLIMITED LLC
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:
1649444589
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/03/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
445 PLEASANT VALLEY WAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WEST ORANGE
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07052-2919
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
973-577-5200
Provider Business Mailing Address Fax Number:
976-577-5201

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
445 PLEASANT VALLEY WAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WEST ORANGE
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07052-2919
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
973-577-2000
Provider Business Practice Location Address Fax Number:
973-577-5201
Provider Enumeration Date:
04/22/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
CARDINALE
Authorized Official First Name:
MARY PAT
Authorized Official Middle Name:
Authorized Official Title or Position:
PRACTICE ADMINISTRATOR
Authorized Official Telephone Number:
973-577-5200

Provider Taxonomy Codes

  • Taxonomy code: 207XX0005X , with the licence number:  MA67795 , 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: 1649444589 . This is a "MEDICARE DME NPI" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 136755 . This is a "MEDICARE GROUP PTAN" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 1508812330 . This is a "MEDICARE INDIVIDUAL NPI" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 1649444589 . This is a "MEDICARE GROUP NPI" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".