Provider Demographics
NPI:1992383780
Name:NORTH JERSEY SPORTS MEDICINE & ORTHOPEDIC CENTER, LLC
Entity Type:Organization
Organization Name:NORTH JERSEY SPORTS MEDICINE & ORTHOPEDIC CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHEIDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-684-2480
Mailing Address - Street 1:376 LAFAYETTE RD STE 202
Mailing Address - Street 2:
Mailing Address - City:SPARTA
Mailing Address - State:NJ
Mailing Address - Zip Code:07871-3560
Mailing Address - Country:US
Mailing Address - Phone:908-684-2480
Mailing Address - Fax:
Practice Address - Street 1:711 ROUTE 10 E STE 100
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:NJ
Practice Address - Zip Code:07869-2030
Practice Address - Country:US
Practice Address - Phone:908-684-3005
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-01
Last Update Date:2021-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty