Provider Demographics
NPI:1710964390
Name:ALTMAN, WAYNE J (MD)
Entity Type:Individual
Prefix:MR
First Name:WAYNE
Middle Name:J
Last Name:ALTMAN
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Gender:M
Credentials:MD
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Mailing Address - Street 1:85 ORIENT WAY
Mailing Address - Street 2:FIRST FLOOR
Mailing Address - City:RUTHERFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07070
Mailing Address - Country:US
Mailing Address - Phone:201-438-5888
Mailing Address - Fax:201-438-6825
Practice Address - Street 1:85 ORIENT WAY
Practice Address - Street 2:1ST FL
Practice Address - City:RUTHERFORD
Practice Address - State:NJ
Practice Address - Zip Code:07070
Practice Address - Country:US
Practice Address - Phone:201-438-5888
Practice Address - Fax:201-438-6825
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-27
Last Update Date:2010-07-01
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Provider Licenses
StateLicense IDTaxonomies
NJM36854207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
C55588Medicare UPIN
NJAL454308Medicare ID - Type Unspecified