Healthcare Provider Details

I. General information

NPI: 1306175690
Provider Name (Legal Business Name): CHILDREN FIRST ORTHOPEDICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2009
Last Update Date: 12/15/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

194 MAIN ST
MILLBURN NJ
07041-1144
US

IV. Provider business mailing address

194 MAIN ST
MILLBURN NJ
07041-1144
US

V. Phone/Fax

Practice location:
  • Phone: 973-258-1010
  • Fax: 973-258-4030
Mailing address:
  • Phone: 973-258-1010
  • Fax: 973-258-4030

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XP3100X
TaxonomyPediatric Orthopaedic Surgery Physician
License Number25MA06579400
License Number StateNJ

VIII. Authorized Official

Name: MR. FRANK J LIGGIO
Title or Position: DOCTOR
Credential: M.D.
Phone: 973-258-1010