Healthcare Provider Details

I. General information

NPI: 1679520340
Provider Name (Legal Business Name): CENTRAL PHYSICIANS & SURGEONS PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2006
Last Update Date: 08/23/2021
Certification Date: 08/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

403 COMMERCE LN STE 3
WEST BERLIN NJ
08091-2513
US

IV. Provider business mailing address

403 COMMERCE LN STE 3
WEST BERLIN NJ
08091-2513
US

V. Phone/Fax

Practice location:
  • Phone: 856-767-8787
  • Fax: 856-767-6140
Mailing address:
  • Phone: 856-767-8787
  • Fax: 856-767-6140

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number33179
License Number StateNJ

VIII. Authorized Official

Name: DR. ROY B FRIEDENTHAL
Title or Position: PRESIDENT OF CORPORATION
Credential: MD
Phone: 609-561-8787