Healthcare Provider Details

I. General information

NPI: 1871642900
Provider Name (Legal Business Name): ORTHOSURG PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2007
Last Update Date: 07/30/2025
Certification Date: 07/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 MADISON AVE
MORRISTOWN NJ
07960-6136
US

IV. Provider business mailing address

127 PERSHING BLVD
LAVALLETTE NJ
08735-2836
US

V. Phone/Fax

Practice location:
  • Phone: 973-971-5532
  • Fax:
Mailing address:
  • Phone: 908-797-8011
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License Number26NO06769800
License Number StateNJ

VIII. Authorized Official

Name: COLLEEN DEVITA
Title or Position: PRESIDENT
Credential: RN BSN CNOR CRNFA
Phone: 908-797-8011