Provider Demographics
NPI:1043286735
Name:ORTHOPAEDIC INSTITUTE OF CENTRAL JERSEY
Entity Type:Organization
Organization Name:ORTHOPAEDIC INSTITUTE OF CENTRAL JERSEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:MELESKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-974-0404
Mailing Address - Street 1:2315 ROUTE 34 SOUTH
Mailing Address - Street 2:SUITE D
Mailing Address - City:MANASQUAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08736-1423
Mailing Address - Country:US
Mailing Address - Phone:732-974-0404
Mailing Address - Fax:732-974-3180
Practice Address - Street 1:2315 RT 34 SO.
Practice Address - Street 2:SUITE D
Practice Address - City:MANASQUAN
Practice Address - State:NJ
Practice Address - Zip Code:08736-1423
Practice Address - Country:US
Practice Address - Phone:732-974-0404
Practice Address - Fax:732-974-3180
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
C30811OtherRAILROAD
C30811OtherRAILROAD
1017220001Medicare NSC