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General NPI Number Information
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NPI Number | 1295490316
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Entity Type | Organization
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Legal Business Name | ACADEMY ORTHOPAEDIC GROUP LLC
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Dates
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Enumeration Date | 11/03/2021
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Last Update Date | 09/18/2025
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Provider Practice Location Address
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Address Line | 504 VALLEY RD STE 201
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City | WAYNE
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State | NJ
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Zip | 07470-3534
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Country | US
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Telephone | 973-446-7500
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Fax | 973-554-4922
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Provider Business Mailing Address
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Address Line | 504 VALLEY RD STE 201
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City | WAYNE
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State | NJ
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Zip | 07470-3534
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | MATTHEW DAVID HARTWICK
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Credential |
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Telephone | 973-446-7500
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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 |
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License Number State |
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