Healthcare Provider Details

I. General information

NPI: 1396787990
Provider Name (Legal Business Name): NORTH JERSEY ORTHOPAEDIC SPECIALISTS P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2006
Last Update Date: 05/12/2022
Certification Date: 05/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

730 PALISADE AVE
TEANECK NJ
07666-4000
US

IV. Provider business mailing address

730 PALISADE AVE
TEANECK NJ
07666-3144
US

V. Phone/Fax

Practice location:
  • Phone: 201-353-9000
  • Fax: 201-530-0002
Mailing address:
  • Phone: 201-353-9000
  • Fax: 201-530-0002

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 Code261QM1200X
TaxonomyMagnetic Resonance Imaging (MRI) Clinic/Center
License Number24301
License Number StateNJ

VIII. Authorized Official

Name: JOHN M OWENS
Title or Position: PARTNER
Credential: MD
Phone: 201-353-9000