Healthcare Provider Details

I. General information

NPI: 1558563494
Provider Name (Legal Business Name): ROTHMAN INSTITUTE OF NEW JERSEY, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2007
Last Update Date: 04/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 ENGLISH CREEK AVE BUILDING 1300
EGG HARBOR TOWNSHIP NJ
08234-5549
US

IV. Provider business mailing address

2500 ENGLISH CREEK AVE BUILDING 1300
EGG HARBOR TOWNSHIP NJ
08234-5549
US

V. Phone/Fax

Practice location:
  • Phone: 609-677-6060
  • Fax: 609-677-6061
Mailing address:
  • Phone: 609-677-6060
  • Fax: 609-677-6061

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL E. WEST
Title or Position: CEO
Credential:
Phone: 267-339-3680