Basic Information
| Provider Information | |||||||||
| NPI: | 1396911129 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ROTHMAN INSTITUTE OF NEW JERSEY P A | ||||||||
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| Mailing Information | |||||||||
| Address1: | 443 LAUREL OAK RD | ||||||||
| Address2: | SUITE 130 | ||||||||
| City: | VOORHEES | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080434419 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8568216360 | ||||||||
| FaxNumber: | 8568216359 | ||||||||
| Practice Location | |||||||||
| Address1: | 443 LAUREL OAK RD | ||||||||
| Address2: | SUITE 130 | ||||||||
| City: | VOORHEES | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080434419 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8568216360 | ||||||||
| FaxNumber: | 8568216359 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/01/2008 | ||||||||
| LastUpdateDate: | 05/01/2008 | ||||||||
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| AuthorizedOfficialLastName: | WEST | ||||||||
| AuthorizedOfficialFirstName: | MICHAEL | ||||||||
| AuthorizedOfficialMiddleName: | E. | ||||||||
| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 2673393680 | ||||||||
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| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | ROTHMAN INSTITUTE OF NEW JERSEY P A | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207XS0117X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Orthopaedic Surgery of the Spine |
No ID Information.