Provider Demographics
NPI:1649376310
Name:OPPENHEIM, WILLIAM C (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:C
Last Name:OPPENHEIM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 MILLBURN AVE
Mailing Address - Street 2:SUITE 104B
Mailing Address - City:MILLBURN
Mailing Address - State:NJ
Mailing Address - Zip Code:07041
Mailing Address - Country:US
Mailing Address - Phone:973-379-1991
Mailing Address - Fax:973-467-8647
Practice Address - Street 1:225 MILLBURN AVE
Practice Address - Street 2:SUITE 104 B
Practice Address - City:MILLBURN
Practice Address - State:NJ
Practice Address - Zip Code:07041-1737
Practice Address - Country:US
Practice Address - Phone:973-379-1991
Practice Address - Fax:973-467-8647
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-16
Last Update Date:2016-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA2618207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
C54677Medicare UPIN
44451Medicare ID - Type Unspecified