North Jersey Sports Medicine & Orthopedic Center, LLC

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

License

25MB069711 Issued in NJ

Legal business name

NORTH JERSEY SPORTS MEDICINE & ORTHOPEDIC CENTER, LLC

Doing business as

The Orthopedic Institute of New Jersey

Practice address

218 Ridgedale Ave Ste 202
Cedar Knolls, NJ 07927-2109

Phone

(908) 684-3005

Fax

(908) 684-3301

NPI assigned

Dec 19, 2017

Organization subpart

No

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

Authorized official

Name

Robert A Defalco Jr., DO

Title

Physician-Owner

Phone

(908) 684-3005

Specialties & licenses 1

Addresses

Other names 1

• The Orthopedic Institute of New Jersey Doing business as

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

{
    "created_epoch": "1513641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1513641600000",
    "number": "1215443841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 BILBY RD STE 201",
            "city": "HACKETTSTOWN",
            "state": "NJ",
            "postal_code": "078404174",
            "telephone_number": "908-684-3005",
            "fax_number": "908-684-3301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 RIDGEDALE AVE STE 202",
            "city": "CEDAR KNOLLS",
            "state": "NJ",
            "postal_code": "079272109",
            "telephone_number": "908-684-3005",
            "fax_number": "908-684-3301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH JERSEY SPORTS MEDICINE & ORTHOPEDIC CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-19",
        "last_updated": "2017-12-19",
        "status": "A",
        "authorized_official_last_name": "DEFALCO",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PHYSICIAN-OWNER",
        "authorized_official_telephone_number": "908-684-3005",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "NJ",
            "license": "25MB069711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Orthopedic Institute of New Jersey",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Sports Medicine (Orthopaedic Surgery) Physician in Cedar Knolls, NJ
• Providers in Cedar Knolls, NJ by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2017; 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.