Active NPI
Specialty Orthopaedics of New Jersey, PA
- Specialist
- Ridgewood, NJ
National Provider Identifier
1174580807
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- MA33233
- Legal business name
- SPECIALTY ORTHOPAEDICS OF NEW JERSEY, PA
- Practice address
- 1124 E Ridgewood Ave
201
Ridgewood, NJ 07450-3915 - Phone
- (201) 447-1188
- Fax
- (201) 447-8935
- NPI assigned
- Apr 27, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- David P Rudman, M.D.
- Title
- President
- Phone
- (201) 447-1188
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | MA33233 | NJ | Primary |
| Specialist | 174400000X | 25MA07771200 | NJ |
Addresses
Primary practice location
1124 E Ridgewood Ave
201
Ridgewood, NJ 07450-3915
Mailing address
1124 E Ridgewood Ave
201
Ridgewood, NJ 07450-3915
Phone (201) 447-1188
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 085563 | Other | NJ | SPECIALTY ORTHOPAEDICS |
Other names 1
- EDWARD B SELF JR MD FACS PA
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Orthopaedic Surgery Physician
- Ridgewood, NJ
- NPI 1821026709
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146096000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1317945600000",
"number": "1174580807",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1124 E RIDGEWOOD AVE",
"address_2": "201",
"city": "RIDGEWOOD",
"state": "NJ",
"postal_code": "074503915",
"telephone_number": "201-447-1188",
"fax_number": "201-447-8935"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1124 E RIDGEWOOD AVE",
"address_2": "201",
"city": "RIDGEWOOD",
"state": "NJ",
"postal_code": "074503915",
"telephone_number": "201-447-1188",
"fax_number": "201-447-8935"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SPECIALTY ORTHOPAEDICS OF NEW JERSEY, PA",
"organizational_subpart": "NO",
"enumeration_date": "2006-04-27",
"last_updated": "2011-10-07",
"status": "A",
"authorized_official_last_name": "RUDMAN",
"authorized_official_first_name": "DAVID",
"authorized_official_middle_name": "P",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "201-447-1188",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Specialist",
"state": "NJ",
"license": "MA33233",
"primary": true
},
{
"code": "174400000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Specialist",
"state": "NJ",
"license": "25MA07771200",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SPECIALTY ORTHOPAEDICS",
"identifier": "085563",
"state": "NJ"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "EDWARD B SELF JR MD FACS PA",
"code": "4",
"type": "Former Legal Business Name"
}
]
}Other providers in Ridgewood, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.