Provider Demographics
NPI:1205264967
Name:PREOP MEDICAL LLC
Entity type:Organization
Organization Name:PREOP MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GORDON
Authorized Official - Middle Name:
Authorized Official - Last Name:DONALD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-440-8707
Mailing Address - Street 1:100 PRINCETON SOUTH CORPORATE CTR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:EWING
Mailing Address - State:NJ
Mailing Address - Zip Code:08628-3439
Mailing Address - Country:US
Mailing Address - Phone:609-235-1600
Mailing Address - Fax:609-235-1611
Practice Address - Street 1:234 INDUSTRIAL WAY W
Practice Address - Street 2:BUILDING A, SUITE 200
Practice Address - City:EATONTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07724-4244
Practice Address - Country:US
Practice Address - Phone:732-440-8707
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-16
Last Update Date:2013-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ207XS0117X, 363AS0400X
207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Multi-Specialty
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Multi-Specialty