Provider Demographics
NPI:1326229840
Name:ORTHOPEDIC SPECIALIST OF NEW JERSEY PA
Entity Type:Organization
Organization Name:ORTHOPEDIC SPECIALIST OF NEW JERSEY PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JUNE
Authorized Official - Middle Name:M
Authorized Official - Last Name:VIGILANTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-489-0022
Mailing Address - Street 1:87 SUMMIT AVE
Mailing Address - Street 2:
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-1262
Mailing Address - Country:US
Mailing Address - Phone:201-489-0022
Mailing Address - Fax:201-489-6991
Practice Address - Street 1:87 SUMMIT AVE
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-1262
Practice Address - Country:US
Practice Address - Phone:201-489-0022
Practice Address - Fax:201-489-6991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-27
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty