Provider Demographics
NPI:1275692121
Name:CENTRAL JERSEY ORTHOPAEDIC SPECIALISTS, P.A.
Entity Type:Organization
Organization Name:CENTRAL JERSEY ORTHOPAEDIC SPECIALISTS, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CODING COMPLIANCE OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:LILLIAN
Authorized Official - Middle Name:S
Authorized Official - Last Name:CONVERY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-561-9150
Mailing Address - Street 1:1907 PARK AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SOUTH PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07080-5530
Mailing Address - Country:US
Mailing Address - Phone:908-561-2122
Mailing Address - Fax:908-769-5308
Practice Address - Street 1:1907 PARK AVE
Practice Address - Street 2:102
Practice Address - City:SOUTH PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07080-5530
Practice Address - Country:US
Practice Address - Phone:908-561-2122
Practice Address - Fax:908-769-5308
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-07
Last Update Date:2008-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1324540001Medicare NSC