Provider Demographics
NPI:1609898691
Name:ORTHOPAEDIC AND SPORTS SPECIALISTS, PC
Entity Type:Organization
Organization Name:ORTHOPAEDIC AND SPORTS SPECIALISTS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MGR.
Authorized Official - Prefix:
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROMERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-809-9001
Mailing Address - Street 1:798 S ROUTE 73
Mailing Address - Street 2:
Mailing Address - City:WEST BERLIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08091-2620
Mailing Address - Country:US
Mailing Address - Phone:856-809-9001
Mailing Address - Fax:856-809-9003
Practice Address - Street 1:289 WHITE HORSE PIKE
Practice Address - Street 2:STE 101
Practice Address - City:ATCO
Practice Address - State:NJ
Practice Address - Zip Code:08004-2257
Practice Address - Country:US
Practice Address - Phone:856-809-9001
Practice Address - Fax:856-809-9003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA46475174400000X
225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty