Provider Demographics
NPI:1144765140
Name:CRANBURY ORTHOPEDIC LLC
Entity type:Organization
Organization Name:CRANBURY ORTHOPEDIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JORDAN
Authorized Official - Middle Name:R
Authorized Official - Last Name:SALAHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-490-0036
Mailing Address - Street 1:557 CRANBURY RD STE 10
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-5419
Mailing Address - Country:US
Mailing Address - Phone:732-238-8800
Mailing Address - Fax:732-238-8246
Practice Address - Street 1:557 CRANBURY RD STE 10
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-5419
Practice Address - Country:US
Practice Address - Phone:732-238-8800
Practice Address - Fax:732-238-8246
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-29
Last Update Date:2016-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Single Specialty