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General NPI Number Information
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NPI Number | 1285176628
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Entity Type | Organization
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Legal Business Name | ASSOCIATED ORTHOPAEDICS
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Dates
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Enumeration Date | 11/16/2016
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Last Update Date | 11/16/2016
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Provider Practice Location Address
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Address Line | 4 ROSE CT
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City | WARREN
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State | NJ
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Zip | 07059-5779
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Country | US
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Telephone | 908-358-6410
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Fax |
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Provider Business Mailing Address
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Address Line | 4 ROSE CT
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City | WARREN
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State | NJ
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Zip | 07059-5779
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Country | US
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Telephone | 908-358-6410
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Fax |
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Authorized Official
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Title or Position | DOCOR
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Name | DR. JOHN FACCONE
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Credential | DO
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Telephone | 908-358-6410
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 25MB0631400
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License Number State | NJ
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