MEDICARE: SOUTH JERSEY CENTER FOR ORTHOPEDICS & SPORTS MEDICINE

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	332B00000X	Durable Medical Equipment & Medical Supplies	25MA03585800	NJ
2	207X00000X	Orthopaedic Surgery Physician	MA35858	NJ

General Provider Information

NPI Number	:	1558431296
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTH JERSEY CENTER FOR ORTHOPEDICS & SPORTS MEDICINE

Provider Business Mailing Address
First Line	:	994 W SHERMAN AVE
Second Line	:
City	:	VINELAND
State	:	NJ
Zip	:	08360-6937
Country	:	US
Telephone Number	:	856-696-0900
Fax Number	:	856-692-4769

Provider Business Practice Location Address
First Line	:	994 W SHERMAN AVE
Second Line	:
City	:	VINELAND
State	:	NJ
Zip	:	08360-6937
Country	:	US
Telephone Number	:	856-696-0900
Fax Number	:	856-692-4769

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JOSEPH P BERNARDINI
Credential	:	MD
Telephone Number	:	856-696-0900

Provider Enumeration Date	:	11/09/2006
Last Update Date	:	06/23/2010

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