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General NPI Number Information
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NPI Number | 1780813261
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Entity Type | Organization
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Legal Business Name | CTO ORTHOPAEDICS LLC
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Dates
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Enumeration Date | 07/06/2009
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Last Update Date | 01/07/2010
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Provider Practice Location Address
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Address Line | 351 EVELYN ST 3RD FLOOR
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City | PARAMUS
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State | NJ
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Zip | 07652-2901
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Country | US
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Telephone | 201-265-3111
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Fax | 201-265-3117
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Provider Business Mailing Address
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Address Line | PO BOX 1732
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City | PARAMUS
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State | NJ
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Zip | 07653-1732
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Country | US
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Telephone | 201-265-3111
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CHUKUEKE TOBENNA OKEZIE
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Credential | M.D.
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Telephone | 201-265-3111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 25MA06793200
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License Number State | NJ
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