Healthcare Provider Details

I. General information

NPI: 1952851313
Provider Name (Legal Business Name): NEW JERSEY PODIATRIC PHYSICIANS & SURGEONS GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2016
Last Update Date: 10/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 ROUTE 31 SUITE 700
FLEMINGTON NJ
08822-5744
US

IV. Provider business mailing address

4633 HWY 9
HOWELL NJ
07731-3324
US

V. Phone/Fax

Practice location:
  • Phone: 908-788-1848
  • Fax: 609-883-6160
Mailing address:
  • Phone: 732-994-5333
  • Fax: 732-994-5336

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number StateNJ

VIII. Authorized Official

Name: HAL ORNSTEIN
Title or Position: CEO
Credential: DPM
Phone: 732-994-5333