1659706992 NPI number — ATLANTIC PROSTHETIC & ORTHOTIC SERVICES, INC.

Table of content: FRITZ PARL MD (NPI 1770667891)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659706992 NPI number — ATLANTIC PROSTHETIC & ORTHOTIC SERVICES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ATLANTIC PROSTHETIC & ORTHOTIC SERVICES, INC.
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:
6
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:
1659706992
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/05/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
199 NEW RD
Provider Second Line Business Mailing Address:
SUITE 57
Provider Business Mailing Address City Name:
LINWOOD
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08221-2025
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
609-927-6330
Provider Business Mailing Address Fax Number:
609-927-6366

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
376 EAST WHEAT ROAD
Provider Second Line Business Practice Location Address:
SUITE 4-D
Provider Business Practice Location Address City Name:
VINELAND
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08341
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
856-535-1106
Provider Business Practice Location Address Fax Number:
609-927-6366
Provider Enumeration Date:
09/05/2013

Additional Information

Authorized Official

Authorized Official Last Name:
RUTLEDGE
Authorized Official First Name:
PAUL
Authorized Official Middle Name:
Authorized Official Title or Position:
EXECUTIVE ADMINISTRATOR
Authorized Official Telephone Number:
609-927-6330

Provider Taxonomy Codes

  • Taxonomy code: 335E00000X , with the licence number:  0591651 , 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: 5417406 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".




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