Provider Demographics
NPI:1508130444
Name:CLIFTON ORTHOPEDIC ASSOCIATES P.A.
Entity Type:Organization
Organization Name:CLIFTON ORTHOPEDIC ASSOCIATES P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ORTHOPEDIC SURGEON
Authorized Official - Prefix:
Authorized Official - First Name:EVANGELOS
Authorized Official - Middle Name:
Authorized Official - Last Name:MEGARIOTIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-340-8500
Mailing Address - Street 1:1450 MAIN AVE
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07011-2145
Mailing Address - Country:US
Mailing Address - Phone:973-340-8500
Mailing Address - Fax:973-340-8690
Practice Address - Street 1:1450 MAIN AVE
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07011-2145
Practice Address - Country:US
Practice Address - Phone:973-340-8500
Practice Address - Fax:973-340-8690
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-23
Last Update Date:2012-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03628500207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1421506Medicaid
NJ011564Medicare PIN
NJC52470Medicare UPIN