Provider Demographics
NPI:1063834810
Name:NORTH JERSEY ORTHOPEDIC GROUP L.L.C
Entity Type:Organization
Organization Name:NORTH JERSEY ORTHOPEDIC GROUP L.L.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:DIPAOLO
Authorized Official - Suffix:
Authorized Official - Credentials:MD, DO
Authorized Official - Phone:973-743-0002
Mailing Address - Street 1:1360 CLIFTON AVE
Mailing Address - Street 2:PMB 375
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07012-1343
Mailing Address - Country:US
Mailing Address - Phone:973-743-0002
Mailing Address - Fax:973-743-0026
Practice Address - Street 1:14-20 WATSESSING AVE
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07003-4611
Practice Address - Country:US
Practice Address - Phone:973-743-0002
Practice Address - Fax:973-743-0026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-14
Last Update Date:2014-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA60375207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty