Provider Demographics
NPI:1336694041
Name:ORTHO ACC LLC
Entity Type:Organization
Organization Name:ORTHO ACC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:
Authorized Official - First Name:MICHAL
Authorized Official - Middle Name:HAROLD
Authorized Official - Last Name:RIEBER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-322-7400
Mailing Address - Street 1:200 S ORANGE AVE STE 230
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-5817
Mailing Address - Country:US
Mailing Address - Phone:973-322-7400
Mailing Address - Fax:973-322-7401
Practice Address - Street 1:200 S ORANGE AVE STE 230
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-5817
Practice Address - Country:US
Practice Address - Phone:973-322-7400
Practice Address - Fax:973-322-7401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-23
Last Update Date:2016-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA67795207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Single Specialty