Healthcare Provider Details

I. General information

NPI: 1487865580
Provider Name (Legal Business Name): TRENTON ORTHOPAEDIC GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2007
Last Update Date: 10/21/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 FLORAL VALE BLVD SUITE B
YARDLEY PA
19067-5522
US

IV. Provider business mailing address

1225 WHITEHORSE MERCERVILLE RD BLDG. D, SUITE 220
MERCERVILLE NJ
08619-3882
US

V. Phone/Fax

Practice location:
  • Phone: 609-581-2200
  • Fax: 609-581-1212
Mailing address:
  • Phone: 609-581-2200
  • Fax: 609-581-1212

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number25MA06444100
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number25MA06804200
License Number StateNJ

VIII. Authorized Official

Name: DR. DANIEL J. FLETCHER
Title or Position: MANAGING PARTNER
Credential: M.D.
Phone: 609-581-2200