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General NPI Number Information
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NPI Number | 1578359394
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Entity Type | Organization
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Legal Business Name | NJ ORTHOPEDIC AND SPORTS MEDICINE
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Dates
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Enumeration Date | 04/17/2025
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Last Update Date | 06/19/2025
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Provider Practice Location Address
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Address Line | 185 KINGSLAND ST
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City | NUTLEY
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State | NJ
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Zip | 07110-1119
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Country | US
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Telephone | 855-699-7246
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Fax | 718-766-9763
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Provider Business Mailing Address
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Address Line | PO BOX 70
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City | NUTLEY
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State | NJ
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Zip | 07110-0070
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Country | US
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Telephone | 973-816-2259
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Fax | 718-766-9763
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Authorized Official
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Title or Position | OPERATIONS MANAGER
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Name | MS. NEESHA N MOHAMMED
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Credential |
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Telephone | 201-340-2199
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2081P0004X
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Taxonomy Name | Spinal Cord Injury Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State |
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Taxonomy #4
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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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