Provider Demographics
NPI:1205006053
Name:ASSOCIATES IN ORTHOPAEDIC SURGERY, PA
Entity Type:Organization
Organization Name:ASSOCIATES IN ORTHOPAEDIC SURGERY, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:R
Authorized Official - Last Name:MCCAULEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-467-1212
Mailing Address - Street 1:120 MILLBURN AVE
Mailing Address - Street 2:STE 103
Mailing Address - City:MILLBURN
Mailing Address - State:NJ
Mailing Address - Zip Code:07041-1994
Mailing Address - Country:US
Mailing Address - Phone:973-467-1212
Mailing Address - Fax:973-467-1216
Practice Address - Street 1:120 MILLBURN AVE
Practice Address - Street 2:STE 103
Practice Address - City:MILLBURN
Practice Address - State:NJ
Practice Address - Zip Code:07041-1994
Practice Address - Country:US
Practice Address - Phone:973-467-1212
Practice Address - Fax:973-467-1216
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-07
Last Update Date:2011-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA 037301207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ526376Medicare PIN