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General NPI Number Information
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NPI Number | 1942035621
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Entity Type | Organization
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Legal Business Name | THE PEDIATRIC ORTHOPEDIC CENTER, PA
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Dates
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Enumeration Date | 09/03/2024
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Last Update Date | 09/03/2024
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Provider Practice Location Address
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Address Line | 218 RIDGEDALE AVE STE 101
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City | CEDAR KNOLLS
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State | NJ
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Zip | 07927-2109
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Country | US
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Telephone | 973-538-7700
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Fax | 973-538-9478
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Provider Business Mailing Address
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Address Line | 218 RIDGEDALE AVE STE 101
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City | CEDAR KNOLLS
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State | NJ
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Zip | 07927-2109
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Country | US
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Telephone | 973-538-7700
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Fax | 973-538-9478
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Authorized Official
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Title or Position | COO
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Name | JENNIFER ORRELL
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Credential |
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Telephone | 973-670-5920
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XP3100X
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Taxonomy Name | Pediatric Orthopaedic Surgery Physician
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License Number |
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License Number State |
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