Provider Demographics
NPI: | 1144765140 |
---|---|
Name: | CRANBURY ORTHOPEDIC LLC |
Entity Type: | Organization |
Organization Name: | CRANBURY ORTHOPEDIC LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | BILLING MANAGER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | JORDAN |
Authorized Official - Middle Name: | R |
Authorized Official - Last Name: | SALAHI |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 908-490-0036 |
Mailing Address - Street 1: | 557 CRANBURY RD STE 10 |
Mailing Address - Street 2: | |
Mailing Address - City: | EAST BRUNSWICK |
Mailing Address - State: | NJ |
Mailing Address - Zip Code: | 08816-5419 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 732-238-8800 |
Mailing Address - Fax: | 732-238-8246 |
Practice Address - Street 1: | 557 CRANBURY RD STE 10 |
Practice Address - Street 2: | |
Practice Address - City: | EAST BRUNSWICK |
Practice Address - State: | NJ |
Practice Address - Zip Code: | 08816-5419 |
Practice Address - Country: | US |
Practice Address - Phone: | 732-238-8800 |
Practice Address - Fax: | 732-238-8246 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2016-12-29 |
Last Update Date: | 2016-12-29 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207XS0117X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Orthopaedic Surgery of the Spine | Group - Single Specialty |