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General NPI Number Information
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NPI Number | 1821030545
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Entity Type | Organization
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Legal Business Name | PEDIATRIC ORTHOPEDIC SPECIALTIES, PA
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Dates
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Enumeration Date | 06/10/2006
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Last Update Date | 11/02/2007
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Provider Practice Location Address
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Address Line | 22 MADISON AVE SUITE 3
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City | PARAMUS
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State | NJ
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Zip | 07652-2734
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Country | US
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Telephone | 201-342-4100
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Fax |
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Provider Business Mailing Address
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Address Line | 22 MADISON AVE SUITE 3
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City | PARAMUS
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State | NJ
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Zip | 07652-2734
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Country | US
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Telephone | 201-342-4100
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. RONALD SNYDER
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Credential | MD
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Telephone | 201-342-4100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 25MA06975500
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License Number State | NJ
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