Provider Demographics
NPI:1548213424
Name:UMDNJ RWJ UNIV ORTHOPAEDIC GROUP
Entity Type:Organization
Organization Name:UMDNJ RWJ UNIV ORTHOPAEDIC GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CAROLE
Authorized Official - Middle Name:
Authorized Official - Last Name:PENZYNSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-212-0061
Mailing Address - Street 1:66 W GILBERT ST
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701
Mailing Address - Country:US
Mailing Address - Phone:732-212-0051
Mailing Address - Fax:732-212-0713
Practice Address - Street 1:215 EASTON AVE
Practice Address - Street 2:
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901-1722
Practice Address - Country:US
Practice Address - Phone:732-545-0400
Practice Address - Fax:732-545-0465
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ070398Medicare PIN
NJ070352Medicare PIN