Provider Demographics
NPI:1215015078
Name:NORTHERN NEW JERSEY ORTHOPEDIC SPECIALISTS
Entity Type:Organization
Organization Name:NORTHERN NEW JERSEY ORTHOPEDIC SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHOPEDIC SURGEON
Authorized Official - Prefix:
Authorized Official - First Name:MARC
Authorized Official - Middle Name:A
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-538-4444
Mailing Address - Street 1:4 CAMPUS DR STE 1S
Mailing Address - Street 2:
Mailing Address - City:PARSIPPANY
Mailing Address - State:NJ
Mailing Address - Zip Code:07054-4405
Mailing Address - Country:US
Mailing Address - Phone:973-538-4444
Mailing Address - Fax:973-538-0420
Practice Address - Street 1:ROUTE 94 STE 5E BLDG E
Practice Address - Street 2:VIKING VILLAGE
Practice Address - City:VERNON
Practice Address - State:NJ
Practice Address - Zip Code:07462
Practice Address - Country:US
Practice Address - Phone:973-827-4700
Practice Address - Fax:973-827-0439
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA50155174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0246808Medicaid
NJ0246808Medicaid