Provider Demographics
NPI:1114208857
Name:INSTITUTE FOR NERVE, HAND AND RECONSTRUCTIVE SURGERY LLC
Entity Type:Organization
Organization Name:INSTITUTE FOR NERVE, HAND AND RECONSTRUCTIVE SURGERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:RENATA
Authorized Official - Middle Name:V
Authorized Official - Last Name:WEBER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-582-5072
Mailing Address - Street 1:201 ROUTE 17
Mailing Address - Street 2:11TH FLOOR, ROOM 11056
Mailing Address - City:RUTHERFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07070-2574
Mailing Address - Country:US
Mailing Address - Phone:201-549-8860
Mailing Address - Fax:201-549-8861
Practice Address - Street 1:201 ROUTE 17
Practice Address - Street 2:11TH FLOOR, ROOM 11056
Practice Address - City:RUTHERFORD
Practice Address - State:NJ
Practice Address - Zip Code:07070-2574
Practice Address - Country:US
Practice Address - Phone:201-549-8860
Practice Address - Fax:201-549-8861
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-08
Last Update Date:2011-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA089862002082S0105X
NJ25MA077917002082S0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2082S0105XAllopathic & Osteopathic PhysiciansPlastic SurgerySurgery of the HandGroup - Single Specialty