Provider Demographics
NPI:1639628316
Name:MARKBREITER ORTHOPEDICS PC
Entity Type:Organization
Organization Name:MARKBREITER ORTHOPEDICS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LANCE
Authorized Official - Middle Name:ARLEN
Authorized Official - Last Name:MARKBREITER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:848-208-2748
Mailing Address - Street 1:145 WYCKOFF RD
Mailing Address - Street 2:SUITE 303
Mailing Address - City:EATONTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07724-1878
Mailing Address - Country:US
Mailing Address - Phone:848-208-2748
Mailing Address - Fax:848-208-2745
Practice Address - Street 1:145 WYCKOFF RD
Practice Address - Street 2:SUITE 303
Practice Address - City:EATONTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07724-1878
Practice Address - Country:US
Practice Address - Phone:848-208-2748
Practice Address - Fax:848-208-2745
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-23
Last Update Date:2016-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty