Provider Demographics
NPI:1003038050
Name:UNION MIDDLESEX ORTHOPEDICS PC
Entity Type:Organization
Organization Name:UNION MIDDLESEX ORTHOPEDICS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ERIC
Authorized Official - Last Name:GROSS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-686-5444
Mailing Address - Street 1:2333 MORRIS AVE
Mailing Address - Street 2:SUITE A 115
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-5714
Mailing Address - Country:US
Mailing Address - Phone:908-686-5444
Mailing Address - Fax:908-686-3599
Practice Address - Street 1:2333 MORRIS AVE
Practice Address - Street 2:SUITE A 115
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-5714
Practice Address - Country:US
Practice Address - Phone:908-686-5444
Practice Address - Fax:908-686-3599
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2010-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05573200207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4559509Medicaid
NJ663364Medicare ID - Type Unspecified
NJ4559509Medicaid