MEDICARE: ROTHMAN INSTITUTE OF NEW JERSEY, P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	335E00000X	Prosthetic/Orthotic Supplier

General Provider Information

NPI Number	:	1073026761
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROTHMAN INSTITUTE OF NEW JERSEY, P.A.

Provider Business Mailing Address
First Line	:	833 CHESTNUT ST STE 1402
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19107-4404
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 SHEFFIELD DR STE 202A
Second Line	:
City	:	COLUMBUS
State	:	NJ
Zip	:	08022-9506
Country	:	US
Telephone Number	:	609-581-2200
Fax Number	:

Authorized Official
Title or Position	:	BUSINESS OFFICE MANAGER
Name	:	GINA MARIE PINO
Credential	:
Telephone Number	:	267-339-3500

Provider Enumeration Date	:	11/16/2017
Last Update Date	:	11/16/2017

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Directions to “ROTHMAN INSTITUTE OF NEW JERSEY, P.A. ” Practice Location

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