Provider Demographics
NPI:1245725191
Name:CITY ORTHOPAEDICS & SPORTS MEDICINE LLC
Entity type:Organization
Organization Name:CITY ORTHOPAEDICS & SPORTS MEDICINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LAYLA
Authorized Official - Middle Name:
Authorized Official - Last Name:BARAKAT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-500-9450
Mailing Address - Street 1:196 PATERSON AVE STE 302
Mailing Address - Street 2:
Mailing Address - City:EAST RUTHERFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07073-1841
Mailing Address - Country:US
Mailing Address - Phone:201-500-9450
Mailing Address - Fax:201-500-9451
Practice Address - Street 1:196 PATERSON AVE STE 302
Practice Address - Street 2:
Practice Address - City:EAST RUTHERFORD
Practice Address - State:NJ
Practice Address - Zip Code:07073-1841
Practice Address - Country:US
Practice Address - Phone:201-500-9450
Practice Address - Fax:201-500-9451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-24
Last Update Date:2024-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty