Healthcare Provider Details

I. General information

NPI: 1336166636
Provider Name (Legal Business Name): TRENTON ORTHOPAEDIC GROUP, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2006
Last Update Date: 01/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1225 WHITEHORSE MERCERVILLE RD SUITE 220
MERCERVILLE NJ
08619-3882
US

IV. Provider business mailing address

1225 WHITEHORSE MERCERVILLE RD SUITE 220
MERCERVILLE NJ
08619-3882
US

V. Phone/Fax

Practice location:
  • Phone: 609-581-2200
  • Fax: 609-581-1212
Mailing address:
  • Phone: 609-581-2200
  • Fax: 609-581-1212

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM1200X
TaxonomyMagnetic Resonance Imaging (MRI) Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. DANIEL J. FLETCHER
Title or Position: MANAGING PARTNER
Credential: MD
Phone: 609-581-2200