Provider Demographics
NPI:1407588569
Name:LALL ORTHOPEDICS LLC
Entity Type:Organization
Organization Name:LALL ORTHOPEDICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:AJAY
Authorized Official - Middle Name:C
Authorized Official - Last Name:LALL
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MS
Authorized Official - Phone:201-733-5255
Mailing Address - Street 1:140 N STATE RT 17
Mailing Address - Street 2:STE 321
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-2817
Mailing Address - Country:US
Mailing Address - Phone:201-733-5255
Mailing Address - Fax:201-877-1453
Practice Address - Street 1:140 N STATE RT 17
Practice Address - Street 2:STE 321
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-2817
Practice Address - Country:US
Practice Address - Phone:201-733-5255
Practice Address - Fax:201-877-1453
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-28
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILF400408826Medicaid