Provider Demographics
NPI:1629463351
Name:ROTHMAN INSTITUTE OF NEW JERSEY,P.A
Entity Type:Organization
Organization Name:ROTHMAN INSTITUTE OF NEW JERSEY,P.A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:WEST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-321-9999
Mailing Address - Street 1:219 N WHITE HORSE PIKE
Mailing Address - Street 2:
Mailing Address - City:HAMMONTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08037-1896
Mailing Address - Country:US
Mailing Address - Phone:856-286-4229
Mailing Address - Fax:609-704-7301
Practice Address - Street 1:219 N WHITE HORSE PIKE
Practice Address - Street 2:
Practice Address - City:HAMMONTON
Practice Address - State:NJ
Practice Address - Zip Code:08037-1896
Practice Address - Country:US
Practice Address - Phone:856-286-4229
Practice Address - Fax:609-704-7301
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ROTHMAN INSTITUTE OF NEW JERSEY, P,A,
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-03-31
Last Update Date:2015-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier