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General NPI Number Information
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NPI Number | 1518360957
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Entity Type | Organization
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Legal Business Name | ORTHOPAEDIC SPORTS MEDICINE AND REHABILITATION CENTER, LLC
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Dates
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Enumeration Date | 09/30/2014
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Last Update Date | 01/06/2025
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Provider Practice Location Address
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Address Line | 25 KILMER DR BUILDING 3, SUITE 104
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City | MORGANVILLE
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State | NJ
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Zip | 07751-1564
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Country | US
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Telephone | 732-741-2313
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Fax |
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Provider Business Mailing Address
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Address Line | 80 OAK HILL RD
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City | RED BANK
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State | NJ
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Zip | 07701-5727
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Country | US
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Telephone | 610-547-1057
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | JANA M FOOR
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Credential |
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Telephone | 732-741-2313
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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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