Healthcare Provider Details
I. General information
NPI: 1053448167
Provider Name (Legal Business Name): ESSEX ORTHOPAEDIC GROUP, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/27/2007
Last Update Date: 10/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
36 NEWARK AVE SUITE 220
BELLEVILLE NJ
07109-4119
US
IV. Provider business mailing address
36 NEWARK AVE SUITE 220
BELLEVILLE NJ
07109-4119
US
V. Phone/Fax
- Phone: 973-759-8284
- Fax: 973-751-4156
- Phone: 973-759-8284
- Fax: 973-751-4156
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | MA34734 |
| License Number State | NJ |
VIII. Authorized Official
Name: DR.
DAVID
J
GREIFINGER
Title or Position: PRESIDENT
Credential: M.D.
Phone: 973-759-8284