Healthcare Provider Details

I. General information

NPI: 1649444589
Provider Name (Legal Business Name): ORTHOPAEDICS UNLIMITED LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2008
Last Update Date: 02/03/2022
Certification Date: 02/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

445 PLEASANT VALLEY WAY
WEST ORANGE NJ
07052-2919
US

IV. Provider business mailing address

445 PLEASANT VALLEY WAY
WEST ORANGE NJ
07052-2919
US

V. Phone/Fax

Practice location:
  • Phone: 973-577-2000
  • Fax: 973-577-5201
Mailing address:
  • Phone: 973-577-5200
  • Fax: 976-577-5201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License NumberMA67795
License Number StateNJ

VIII. Authorized Official

Name: MRS. MARY PAT CARDINALE
Title or Position: PRACTICE ADMINISTRATOR
Credential:
Phone: 973-577-5200