Provider Demographics
NPI:1346362027
Name:LAWRENCE ORTHOPAEDICS PC
Entity Type:Organization
Organization Name:LAWRENCE ORTHOPAEDICS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:S
Authorized Official - Last Name:GLICK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-394-9289
Mailing Address - Street 1:4065 QUAKERBRIDGE RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:PRINCETON JUNCTION
Mailing Address - State:NJ
Mailing Address - Zip Code:08550-5200
Mailing Address - Country:US
Mailing Address - Phone:609-394-9289
Mailing Address - Fax:609-989-1550
Practice Address - Street 1:4065 QUAKERBRIDGE RD
Practice Address - Street 2:SUITE 103
Practice Address - City:PRINCETON JUNCTION
Practice Address - State:NJ
Practice Address - Zip Code:08550-5200
Practice Address - Country:US
Practice Address - Phone:609-394-9289
Practice Address - Fax:609-989-1550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2010-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3900801Medicaid
NJ1009630002Medicare NSC
NJ434539Medicare ID - Type UnspecifiedMEDICARE GROUP PROVIDER