Provider Demographics
NPI:1790062628
Name:NON-SURGICAL ORTHOPEDICS OF NEW JERSEY
Entity Type:Organization
Organization Name:NON-SURGICAL ORTHOPEDICS OF NEW JERSEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:KETAN
Authorized Official - Middle Name:DHRUVKUMAR
Authorized Official - Last Name:VORA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:516-220-8960
Mailing Address - Street 1:465 WASHINGTON BLVD
Mailing Address - Street 2:SUITE 2007 SOUTH
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07310-2117
Mailing Address - Country:US
Mailing Address - Phone:516-220-8960
Mailing Address - Fax:516-717-3556
Practice Address - Street 1:1107 CONVERY BLVD
Practice Address - Street 2:
Practice Address - City:PERTH AMBOY
Practice Address - State:NJ
Practice Address - Zip Code:08861-1937
Practice Address - Country:US
Practice Address - Phone:516-220-8960
Practice Address - Fax:516-717-3556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-07
Last Update Date:2016-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB08561100208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty