Provider Demographics
NPI:1124190210
Name:CENTER FOR ORTHOPEDIC CARE P A
Entity Type:Organization
Organization Name:CENTER FOR ORTHOPEDIC CARE P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:NORDSTROM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-685-8500
Mailing Address - Street 1:215 UNION AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:BRIDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:08807-3063
Mailing Address - Country:US
Mailing Address - Phone:908-685-8500
Mailing Address - Fax:908-685-8009
Practice Address - Street 1:215 UNION AVE
Practice Address - Street 2:SUITE B
Practice Address - City:BRIDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:08807-3063
Practice Address - Country:US
Practice Address - Phone:908-685-8500
Practice Address - Fax:908-685-8009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-14
Last Update Date:2012-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04184700207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ092714Medicare ID - Type UnspecifiedGROUP NUMBER