Organization Active NPI

Garden State Orthopedic and Spine Associates LLC

  • Surgery Physician
  • West Orange, NJ
National Provider Identifier
1063784221
Registry record updated Jun 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
GARDEN STATE ORTHOPEDIC AND SPINE ASSOCIATES LLC
Practice address
475 Prospect Ave Ste 110
West Orange, NJ 07052-4197
Phone
(732) 494-1655
NPI assigned
Feb 3, 2012
Organization subpart
Yes
Parent organization
GARDEN STATE ORTHOPEDIC AND SPINE ASSOCIATES LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 10, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Amy Liu
Title
Ms
Phone
(732) 494-1655

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

475 Prospect Ave Ste 110
West Orange, NJ 07052-4197

Mailing address

475 Prospect Ave Ste 110
West Orange, NJ 07052-4197

National Provider Directory

National Provider Directory
Part of
Garden State Orthopedic and Spine Associates LLC

Locations

855 Lehigh Ave
#204
Union, NJ 07083

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1328227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370822400000",
    "number": "1063784221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 PROSPECT AVE STE 110",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070524197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 PROSPECT AVE STE 110",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070524197",
            "telephone_number": "732-494-1655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARDEN STATE ORTHOPEDIC AND SPINE ASSOCIATES LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GARDEN STATE ORTHOPEDIC AND SPINE ASSOCIATES LLC",
        "enumeration_date": "2012-02-03",
        "last_updated": "2013-06-10",
        "status": "A",
        "authorized_official_last_name": "LIU",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "MS",
        "authorized_official_telephone_number": "732-494-1655"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Orange, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.