Healthcare Provider Details

I. General information

NPI: 1316133564
Provider Name (Legal Business Name): ENGLEWOOD KNEE & SPORTS MEDICINE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2007
Last Update Date: 07/31/2025
Certification Date: 07/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

370 GRAND AVE STE 100
ENGLEWOOD NJ
07631-4109
US

IV. Provider business mailing address

370 GRAND AVE SUITE 100
ENGLEWOOD NJ
07631-4154
US

V. Phone/Fax

Practice location:
  • Phone: 207-567-5700
  • Fax: 207-567-8049
Mailing address:
  • Phone: 207-567-5700
  • Fax: 207-567-8049

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. ROBERT WILLIAM DOIDGE
Title or Position: OWNER/AUTHORIZED OFFICIAL
Credential: DO
Phone: 201-567-5700