Provider Demographics
NPI:1205968633
Name:ATLANTIC ORTHOPAEDIC ASSOCIATES, LLC
Entity type:Organization
Organization Name:ATLANTIC ORTHOPAEDIC ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:AMY
Authorized Official - Middle Name:J
Authorized Official - Last Name:REISMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MPA
Authorized Official - Phone:973-599-9779
Mailing Address - Street 1:91 S JEFFERSON RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:WHIPPANY
Mailing Address - State:NJ
Mailing Address - Zip Code:07981-1037
Mailing Address - Country:US
Mailing Address - Phone:973-599-9779
Mailing Address - Fax:973-599-1179
Practice Address - Street 1:91 S JEFFERSON RD
Practice Address - Street 2:SUITE 201
Practice Address - City:WHIPPANY
Practice Address - State:NJ
Practice Address - Zip Code:07981-1037
Practice Address - Country:US
Practice Address - Phone:973-599-9779
Practice Address - Fax:973-599-1179
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04658900207XX0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic TraumaGroup - Single Specialty