Provider Demographics
NPI:1043718810
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:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:V
Authorized Official - Last Name:PETROSINI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-974-0404
Mailing Address - Street 1:2315 HIGHWAY 34 STE D
Mailing Address - Street 2:
Mailing Address - City:MANASQUAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08736-1444
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1301 ROUTE 72 W STE 290
Practice Address - Street 2:
Practice Address - City:MANAHAWKIN
Practice Address - State:NJ
Practice Address - Zip Code:08050-2483
Practice Address - Country:US
Practice Address - Phone:609-488-5378
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ORTHOPAEDIC INSTITUTE OF CENTRAL JERSEY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-01-26
Last Update Date:2018-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty