MEDICARE: TJ ORTHOPAEDICS AND PAIN MANAGEMENT PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician

General Provider Information

NPI Number	:	1134707334
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TJ ORTHOPAEDICS AND PAIN MANAGEMENT PLLC

Provider Business Mailing Address
First Line	:	1414 NEWKIRK AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11226-6599
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	603 RUGBY RD
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11230-1581
Country	:	US
Telephone Number	:	347-217-6232
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JONATHAN LEWIN
Credential	:
Telephone Number	:	347-217-6232

Provider Enumeration Date	:	03/30/2021
Last Update Date	:	03/30/2021

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