Provider Demographics
NPI:1548395304
Name:NUTLEY ORTHOPAEDIC GROUP, PA
Entity Type:Organization
Organization Name:NUTLEY ORTHOPAEDIC GROUP, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHOPAEDIC SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:P
Authorized Official - Last Name:FEMINO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-751-0111
Mailing Address - Street 1:45 FRANKLIN AVE
Mailing Address - Street 2:
Mailing Address - City:NUTLEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07110-3224
Mailing Address - Country:US
Mailing Address - Phone:973-751-0111
Mailing Address - Fax:973-251-9029
Practice Address - Street 1:45 FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:NUTLEY
Practice Address - State:NJ
Practice Address - Zip Code:07110-3224
Practice Address - Country:US
Practice Address - Phone:973-751-0111
Practice Address - Fax:973-251-9029
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJG91542Medicare UPIN
NJ5169930001Medicare NSC
NJG56639Medicare UPIN