Provider Demographics
NPI:1174609309
Name:ORTHOPAEDIC SURGERY CENTER OF NORTHWEST JERSEY, LLC
Entity type:Organization
Organization Name:ORTHOPAEDIC SURGERY CENTER OF NORTHWEST JERSEY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ABRAHAM
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSENZWEIG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-328-3475
Mailing Address - Street 1:3130 ROUTE 10 WEST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DENVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07834
Mailing Address - Country:US
Mailing Address - Phone:973-328-3475
Mailing Address - Fax:973-328-3476
Practice Address - Street 1:3130 ROUTE 10 WEST
Practice Address - Street 2:
Practice Address - City:DENVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07834
Practice Address - Country:US
Practice Address - Phone:973-328-3475
Practice Address - Fax:973-328-3476
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-31
Last Update Date:2009-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22964261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
31C0001150Medicare ID - Type Unspecified
NJ064550Medicare PIN