Provider Demographics
NPI:1558420042
Name:J C ORTHOPEDIC INC
Entity Type:Organization
Organization Name:J C ORTHOPEDIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:J
Authorized Official - Last Name:DIGIRONIMO
Authorized Official - Suffix:JR
Authorized Official - Credentials:LPO
Authorized Official - Phone:732-458-7900
Mailing Address - Street 1:1680 ROUTE 88
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08724-3051
Mailing Address - Country:US
Mailing Address - Phone:732-458-7900
Mailing Address - Fax:732-458-7902
Practice Address - Street 1:1680 ROUTE 88
Practice Address - Street 2:
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08724-3051
Practice Address - Country:US
Practice Address - Phone:732-458-7900
Practice Address - Fax:732-458-7902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-08
Last Update Date:2010-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ332B00000X
NJ45PO00009900335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3228304Medicaid
NJ0166270001Medicare NSC