Provider Demographics
NPI:1114357175
Name:NEW JERSEY PODIATRIC PHYSICIANS AND SURGEONS GROUP, LLC
Entity Type:Organization
Organization Name:NEW JERSEY PODIATRIC PHYSICIANS AND SURGEONS GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:HAL
Authorized Official - Middle Name:
Authorized Official - Last Name:ORNSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-994-5333
Mailing Address - Street 1:4633 HWY 9
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07731-3324
Mailing Address - Country:US
Mailing Address - Phone:732-994-5333
Mailing Address - Fax:
Practice Address - Street 1:53 MAIN ST
Practice Address - Street 2:
Practice Address - City:SAYREVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08872-1559
Practice Address - Country:US
Practice Address - Phone:732-679-4330
Practice Address - Fax:732-679-4777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-12
Last Update Date:2013-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00268400213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty