Provider Demographics
NPI:1407246945
Name:NJ ORTHO GROUP
Entity Type:Organization
Organization Name:NJ ORTHO GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:GORDON
Authorized Official - Middle Name:DUTHIE
Authorized Official - Last Name:DONALD
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:732-542-6000
Mailing Address - Street 1:234 INDUSTRIAL WAY W
Mailing Address - Street 2:SUITE A200
Mailing Address - City:EATONTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07724-4244
Mailing Address - Country:US
Mailing Address - Phone:732-542-6000
Mailing Address - Fax:732-542-6001
Practice Address - Street 1:234 INDUSTRIAL WAY W
Practice Address - Street 2:SUITE A200
Practice Address - City:EATONTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07724-4244
Practice Address - Country:US
Practice Address - Phone:732-542-6000
Practice Address - Fax:732-542-6001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-04
Last Update Date:2015-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ0400359999261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty