Provider Demographics
NPI:1477636876
Name:ORTHOPAEDIC CENTER OF NEW JERSEY
Entity Type:Organization
Organization Name:ORTHOPAEDIC CENTER OF NEW JERSEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:I
Authorized Official - Last Name:HALBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-249-4444
Mailing Address - Street 1:1527 STATE HIGHWAY 27
Mailing Address - Street 2:SUITE 1300
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873
Mailing Address - Country:US
Mailing Address - Phone:732-249-4444
Mailing Address - Fax:732-249-6528
Practice Address - Street 1:1527 STATE HIGHWAY 27
Practice Address - Street 2:SUITE 1300
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873
Practice Address - Country:US
Practice Address - Phone:732-249-4444
Practice Address - Fax:732-249-6528
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2010-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ859588Medicare PIN
NJ0269090001Medicare NSC
NJCC8492Medicare PIN