Healthcare Provider Details

I. General information

NPI: 1487494480
Provider Name (Legal Business Name): MOTION ORTHOPEDICS OF NJ, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2024
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

444 MARKET ST STE 5
SADDLE BROOK NJ
07663-5996
US

IV. Provider business mailing address

520 FRANKLIN AVE STE 211
GARDEN CITY NY
11530-5815
US

V. Phone/Fax

Practice location:
  • Phone: 212-355-5555
  • Fax: 877-992-0798
Mailing address:
  • Phone: 212-355-5555
  • Fax: 877-992-0798

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207XX0004X
TaxonomyOrthopaedic Foot and Ankle Surgery Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number
License Number State

VIII. Authorized Official

Name: ANDREW MCCULLOCH
Title or Position: COO
Credential:
Phone: 734-645-3899