Provider Demographics
NPI:1235374976
Name:MICHAEL BETSY, M.D. ORTHOPAEDIC SURGERY AND SPORTS MEDICINE, L.L.C.
Entity Type:Organization
Organization Name:MICHAEL BETSY, M.D. ORTHOPAEDIC SURGERY AND SPORTS MEDICINE, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHOPAEDIC SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BETSY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-391-1133
Mailing Address - Street 1:577 CHESTNUT RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:WOODCLIFF LAKE
Mailing Address - State:NJ
Mailing Address - Zip Code:07677-8409
Mailing Address - Country:US
Mailing Address - Phone:201-391-1133
Mailing Address - Fax:201-391-3039
Practice Address - Street 1:577 CHESTNUT RIDGE RD
Practice Address - Street 2:
Practice Address - City:WOODCLIFF LAKE
Practice Address - State:NJ
Practice Address - Zip Code:07677-8409
Practice Address - Country:US
Practice Address - Phone:201-391-1133
Practice Address - Fax:201-391-3039
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-10
Last Update Date:2020-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA077358207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty