Provider Demographics
NPI:1609072008
Name:ATLANTIC BONE & JOINT SURGEONS
Entity Type:Organization
Organization Name:ATLANTIC BONE & JOINT SURGEONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:J
Authorized Official - Last Name:NAAME
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-641-2123
Mailing Address - Street 1:518 LAZY LN
Mailing Address - Street 2:
Mailing Address - City:ABSECON
Mailing Address - State:NJ
Mailing Address - Zip Code:08201-1337
Mailing Address - Country:US
Mailing Address - Phone:609-641-2123
Mailing Address - Fax:609-641-2098
Practice Address - Street 1:518 LAZY LN
Practice Address - Street 2:
Practice Address - City:ABSECON
Practice Address - State:NJ
Practice Address - Zip Code:08201-1337
Practice Address - Country:US
Practice Address - Phone:609-641-2123
Practice Address - Fax:609-641-2098
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-22
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ299940401Medicaid