Provider Demographics
NPI:1558378158
Name:NORTHERN JERSEY ORTHOPEDIC CENTER,PA
Entity Type:Organization
Organization Name:NORTHERN JERSEY ORTHOPEDIC CENTER,PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:L
Authorized Official - Last Name:PFISTERER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-836-1663
Mailing Address - Street 1:870 PALISADE AVE
Mailing Address - Street 2:205
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-3419
Mailing Address - Country:US
Mailing Address - Phone:201-836-1663
Mailing Address - Fax:201-836-5729
Practice Address - Street 1:870 PALISADE AVE
Practice Address - Street 2:205
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-3419
Practice Address - Country:US
Practice Address - Phone:201-836-1663
Practice Address - Fax:201-836-5729
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-03
Last Update Date:2010-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA042333207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ892982Medicare ID - Type Unspecified
NJC60191Medicare UPIN