Provider Demographics
NPI:1780972083
Name:GARDEN STATE BONE AND JOINT SPECIALISTS, LLC
Entity type:Organization
Organization Name:GARDEN STATE BONE AND JOINT SPECIALISTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:DR
Authorized Official - First Name:CRISTOBAL
Authorized Official - Middle Name:
Authorized Official - Last Name:BEIRO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-283-2663
Mailing Address - Street 1:1000 ROUTE 9 N STE 306
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07095-1200
Mailing Address - Country:US
Mailing Address - Phone:732-283-2663
Mailing Address - Fax:732-283-2661
Practice Address - Street 1:1000 ROUTE 9 N STE 306
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07095-1200
Practice Address - Country:US
Practice Address - Phone:732-283-2663
Practice Address - Fax:732-283-2661
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-20
Last Update Date:2013-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty