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General NPI Number Information
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NPI Number | 1972673713
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Entity Type | Organization
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Legal Business Name | HAND SURGERY & REHABILITATION CENTER OF NEW JERSEY, PA
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Dates
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Enumeration Date | 11/09/2006
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Last Update Date | 06/06/2014
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Provider Practice Location Address
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Address Line | 5000 SAGEMORE DR SUITE 103
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City | MARLTON
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State | NJ
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Zip | 08053-4307
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Country | US
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Telephone | 856-983-4263
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Fax | 856-983-0674
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Provider Business Mailing Address
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Address Line | 5000 SAGEMORE DRIVE SUITE 103
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City | MARLTON
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State | NJ
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Zip | 08053
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Country | US
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Telephone | 856-983-4263
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Fax | 856-983-9362
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Authorized Official
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Title or Position | PRESIDENT
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Name | FREDERICK L. BALLET
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Credential | M.D.
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Telephone | 856-983-4263
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0105X
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Taxonomy Name | Surgery of the Hand (Surgery) Physician
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License Number | 24019
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License Number State | NJ
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