Provider Demographics
NPI:1942274253
Name:ORTHOPEDIC GROUP, P.A.
Entity Type:Organization
Organization Name:ORTHOPEDIC GROUP, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:A
Authorized Official - Last Name:SIEGEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-538-0029
Mailing Address - Street 1:261 JAMES STREET
Mailing Address - Street 2:SUITE 3F
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960
Mailing Address - Country:US
Mailing Address - Phone:973-538-0029
Mailing Address - Fax:973-538-4957
Practice Address - Street 1:261 JAMES STREET
Practice Address - Street 2:SUITE 3F
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960
Practice Address - Country:US
Practice Address - Phone:973-538-0029
Practice Address - Fax:973-538-4957
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-14
Last Update Date:2014-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ30215207X00000X
NJ22265207X00000X
NJMA072285207X00000X
64517207X00000X
207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
5299810002Medicare NSC