MEDICARE: MR. HORST OERTEL C.P.

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	1744P3200X	Prosthetics Case Management	CP763	NJ

General Provider Information

NPI Number	:	1851398390
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. HORST OERTEL C.P.

Provider Business Mailing Address
First Line	:	916 SOMERSET ST
Second Line	:
City	:	WATCHUNG
State	:	NJ
Zip	:	07069-6305
Country	:	US
Telephone Number	:	908-757-2702
Fax Number	:	908-757-0744

Provider Business Practice Location Address
First Line	:	916 SOMERSET ST
Second Line	:
City	:	WATCHUNG
State	:	NJ
Zip	:	07069-6305
Country	:	US
Telephone Number	:	908-757-2702
Fax Number	:	908-757-0744

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/30/2005
Last Update Date	:	07/08/2007

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