MEDICARE: PREMIER ORTHOPAEDIC OF SOUTH JERSEY

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	207X00000X	Orthopaedic Surgery Physician	MA054868	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2423391000	OTHER	NJ	INDEPENDENCE BLUE CROSS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	610073	OTHER	NJ	ADMINISTRATORS
4	1271200	OTHER	NJ	CIGNA
5	7002746	OTHER	NJ	AETNA
6	2423391000	OTHER	NJ	AMERIHEALTH
7	2423391000	OTHER	NJ	KEYSTONE

General Provider Information

NPI Number	:	1750426151
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PREMIER ORTHOPAEDIC OF SOUTH JERSEY

Provider Business Mailing Address
First Line	:	1007 MANTUA PIKE
Second Line	:
City	:	WOODBURY
State	:	NJ
Zip	:	08096-3963
Country	:	US
Telephone Number	:	856-853-8004
Fax Number	:	856-853-8022

Provider Business Practice Location Address
First Line	:	1007 MANTUA PIKE
Second Line	:
City	:	WOODBURY
State	:	NJ
Zip	:	08096-3963
Country	:	US
Telephone Number	:	856-853-8004
Fax Number	:	856-853-8022

Authorized Official
Title or Position	:	DR
Name	:	TODD M LIPSCHULTZ
Credential	:	MD
Telephone Number	:	856-853-8004

Provider Enumeration Date	:	02/21/2007
Last Update Date	:	04/20/2008

Similar Medicare Providers

1962407221 — THOMAS J STEFFE M.D.
Practice Location Address:

1007 MANTUA PIKE, SUITE B
WOODBURY, NJ
08096-3963

Practice Phone: 856-256-7705
Practice Fax: 856-256-7709

1003811233 — DR. FREDERICK B LAVAN M.D.
Practice Location Address:

1007 MANTUA PIKE, SUITE B
WOODBURY, NJ
08096-3963

Practice Phone: 856-256-7705
Practice Fax: 856-256-7709

1811992860 — PLASTIC & COSMETIC SURGICAL GROUP OF NEW JERSEY, P.C.
Practice Location Address:

1007 MANTUA PIKE, SUITE B
WOODBURY, NJ
08096-3963

Practice Phone: 856-256-7705
Practice Fax: 856-256-7709

1619902897 — MICHAEL JOHN DONOGHUE PT ATC
Practice Location Address:

1007 MANTUA PIKE
WOODBURY, NJ
08096-3963

Practice Phone: 856-845-1253
Practice Fax: 856-845-3779

1699794784 — TEAM REHAB P.A
Practice Location Address:

1007 MANTUA PIKE
WOODBURY, NJ
08096-3963

Practice Phone: 856-845-1253
Practice Fax: 856-845-3779

1801093521 — ADVANCED ANESTHESIA AND PAIN
Practice Location Address:

1007 MANTUA PIKE
WOODBURY, NJ
08096-3963

Practice Phone: 856-697-1158
Practice Fax: 856-697-0772

Directions to “PREMIER ORTHOPAEDIC OF SOUTH JERSEY ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.