Provider Demographics
NPI:1073601373
Name:A. PARKS ORTHOPEDICS, L.L.C
Entity Type:Organization
Organization Name:A. PARKS ORTHOPEDICS, L.L.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:L
Authorized Official - Last Name:PARKS
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:973-661-1833
Mailing Address - Street 1:175 FRANKLIN AVENUE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:NUTLEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07110-1253
Mailing Address - Country:US
Mailing Address - Phone:973-661-1833
Mailing Address - Fax:973-661-2270
Practice Address - Street 1:175 FRANKLIN AVENUE
Practice Address - Street 2:SUITE 103
Practice Address - City:NUTLEY
Practice Address - State:NJ
Practice Address - Zip Code:07110-1253
Practice Address - Country:US
Practice Address - Phone:973-661-1833
Practice Address - Fax:973-661-2270
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-11
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ061227Medicare ID - Type Unspecified