=====================================================
General NPI Number Information
=====================================================
NPI Number | 1568493393
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SOUTH MOUNTAIN ORTHOPAEDIC ASSOCIATES LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/06/2006
-----------------------------------------------------
Last Update Date | 07/01/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 61 1ST ST
-----------------------------------------------------
City | SOUTH ORANGE
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07079-1900
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 973-762-8344
-----------------------------------------------------
Fax | 973-762-1626
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 61 1ST ST
-----------------------------------------------------
City | SOUTH ORANGE
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07079-1900
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 973-762-8344
-----------------------------------------------------
Fax | 973-762-1626
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | V PRES
-----------------------------------------------------
Name | THOMAS E HELBIG
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 973-762-8344
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207X00000X
-----------------------------------------------------
Taxonomy Name | Orthopaedic Surgery Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------