Provider Demographics
NPI:1134154784
Name:THE INSTITUTE OF ORTHOPAEDIC SURGERY AND SPORTS MEDICINE, P.A.
Entity type:Organization
Organization Name:THE INSTITUTE OF ORTHOPAEDIC SURGERY AND SPORTS MEDICINE, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:WONG
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:609-242-6999
Mailing Address - Street 1:731 LACEY RD
Mailing Address - Street 2:STE 4
Mailing Address - City:FORKED RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08731
Mailing Address - Country:US
Mailing Address - Phone:609-242-6999
Mailing Address - Fax:609-242-6922
Practice Address - Street 1:731 LACEY RD
Practice Address - Street 2:STE 4
Practice Address - City:FORKED RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08731
Practice Address - Country:US
Practice Address - Phone:609-242-6999
Practice Address - Fax:609-242-6922
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-12
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty