MEDICARE: ADVANCED ORTHOPEDIC AND SPORTS MEDICINE INSTITUTE PC

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	204C00000X	Sports Medicine (Neuromusculoskeletal Medicine) Physician		NJ
2	207X00000X	Orthopaedic Surgery Physician		NJ

General Provider Information

NPI Number	:	1518033893
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED ORTHOPEDIC AND SPORTS MEDICINE INSTITUTE PC

Provider Business Mailing Address
First Line	:	301 PROFESSIONAL VIEW DR
Second Line	:
City	:	FREEHOLD
State	:	NJ
Zip	:	07728-7904
Country	:	US
Telephone Number	:	732-720-2555
Fax Number	:	732-720-2556

Provider Business Practice Location Address
First Line	:	301 PROFESSIONAL VIEW DR
Second Line	:
City	:	FREEHOLD
State	:	NJ
Zip	:	07728-7904
Country	:	US
Telephone Number	:	732-720-2555
Fax Number	:	732-720-2556

Authorized Official
Title or Position	:	CREDENTIALING SPECIALIST
Name	:	ABBE SCHNEIDER
Credential	:	RMC
Telephone Number	:	732-720-2555

Provider Enumeration Date	:	11/28/2006
Last Update Date	:	04/30/2026

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