Provider Demographics
NPI:1477988988
Name:NORTH EASTERN ORTHOPEDICS
Entity Type:Organization
Organization Name:NORTH EASTERN ORTHOPEDICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:YASER
Authorized Official - Middle Name:
Authorized Official - Last Name:EL-GAZZAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-715-0460
Mailing Address - Street 1:631 GRAND ST
Mailing Address - Street 2:SUITE 2-400, 2ND FLOOR
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07304-3451
Mailing Address - Country:US
Mailing Address - Phone:201-985-8967
Mailing Address - Fax:201-830-2023
Practice Address - Street 1:631 GRAND ST
Practice Address - Street 2:SUITE 2-400, 2ND FLOOR
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07304-3451
Practice Address - Country:US
Practice Address - Phone:201-985-8967
Practice Address - Fax:201-830-2023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-04
Last Update Date:2013-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty