Provider Demographics
NPI:1073524260
Name:ORTHOPEDIC AND NEUROSURGICAL SPECIALISTS, LLC
Entity Type:Organization
Organization Name:ORTHOPEDIC AND NEUROSURGICAL SPECIALISTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:M
Authorized Official - Last Name:DALSEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:856-795-9222
Mailing Address - Street 1:807 N HADDON AVE
Mailing Address - Street 2:
Mailing Address - City:HADDONFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:08033-1749
Mailing Address - Country:US
Mailing Address - Phone:856-795-9222
Mailing Address - Fax:856-795-0126
Practice Address - Street 1:807 N HADDON AVE
Practice Address - Street 2:
Practice Address - City:HADDONFIELD
Practice Address - State:NJ
Practice Address - Zip Code:08033-1749
Practice Address - Country:US
Practice Address - Phone:856-795-9222
Practice Address - Fax:856-795-0126
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-11
Last Update Date:2010-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB07645900207X00000X
NJ25MA05226300207XS0106X
PAMD041578E207XS0106X
NJ25MA05917000207XX0005X
PAMD064219L207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand SurgeryGroup - Multi-Specialty
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4825040001Medicare NSC
NJ057287Medicare ID - Type Unspecified