Provider Demographics
NPI:1750443065
Name:HAL ORNSTEIN ET AL PTR AFFILIATED FOOT & ANKLE CENTER LLP
Entity Type:Organization
Organization Name:HAL ORNSTEIN ET AL PTR AFFILIATED FOOT & ANKLE CENTER LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:GISEL
Authorized Official - Middle Name:
Authorized Official - Last Name:STEPHEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-905-7202
Mailing Address - Street 1:PO BOX 822528
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19182-2528
Mailing Address - Country:US
Mailing Address - Phone:732-905-1110
Mailing Address - Fax:732-905-7885
Practice Address - Street 1:4645 HWY 9
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:NJ
Practice Address - Zip Code:07731-3324
Practice Address - Country:US
Practice Address - Phone:732-905-1110
Practice Address - Fax:732-905-7885
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-14
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6638601Medicaid
NJ659457Medicare PIN
NJ4207950002Medicare NSC