Healthcare Provider Details

I. General information

NPI: 1194914754
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: 08/19/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 N HARRISON ST
PRINCETON NJ
08540-3530
US

IV. Provider business mailing address

2 WORLDS FAIR DR
SOMERSET NJ
08873-1369
US

V. Phone/Fax

Practice location:
  • Phone: 609-683-7800
  • Fax: 609-683-7875
Mailing address:
  • Phone: 732-537-0909
  • Fax: 732-564-9032

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 Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. JOANNE ADAM
Title or Position: COMPLIANCE, CONTRACTS & SYSTEM MGR
Credential: CPC
Phone: 732-537-0909