Provider Demographics
NPI:1669481156
Name:BIOSPORT ORTHOPAEDIC & SPORTS MEDICINE ASSOCIATES, P.A.
Entity Type:Organization
Organization Name:BIOSPORT ORTHOPAEDIC & SPORTS MEDICINE ASSOCIATES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:
Authorized Official - Last Name:REEDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-722-2033
Mailing Address - Street 1:720 US HIGHWAY 202 206
Mailing Address - Street 2:
Mailing Address - City:BRIDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:08807-1746
Mailing Address - Country:US
Mailing Address - Phone:908-722-2033
Mailing Address - Fax:908-707-8344
Practice Address - Street 1:720 US HIGHWAY 202 206
Practice Address - Street 2:
Practice Address - City:BRIDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:08807-1746
Practice Address - Country:US
Practice Address - Phone:908-722-2033
Practice Address - Fax:908-707-8344
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-05
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJDB2488Medicare PIN
NJ526594Medicare PIN