Healthcare Provider Details
I. General information
NPI: 1467641027
Provider Name (Legal Business Name): UNIVERSITY ORTHOPAEDIC ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/19/2007
Last Update Date: 05/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4810 BELMAR BLVD FL 1
NEPTUNE NJ
07753-6952
US
IV. Provider business mailing address
2 WORLDS FAIR DR
SOMERSET NJ
08873-1369
US
V. Phone/Fax
- Phone: 732-774-3880
- Fax: 732-774-5498
- Phone: 732-537-0909
- Fax: 732-564-9032
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208100000X |
| Taxonomy | Physical Medicine & Rehabilitation Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085U0001X |
| Taxonomy | Diagnostic Ultrasound Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JOANNE
WEBER ADAM
Title or Position: BUSINESS OFFICE MANAGER
Credential: CPC
Phone: 732-537-0909