North Jersey Orthopedic Sports Trauma Institute E LLC

Primary specialty

Adult Reconstructive Orthopaedic Surgery PhysicianTaxonomy code 207XS0114X

License

25MA05165000 Issued in NJ

Legal business name

NORTH JERSEY ORTHOPEDIC SPORTS TRAUMA INSTITUTE E LLC

Practice address

15-01 Broadway Ste 20
Fair Lawn, NJ 07410-6003

Phone

(847) 275-3633

NPI assigned

Feb 17, 2015

Organization subpart

No

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

Authorized official

Name

Robert Greenblum

Title

MD

Phone

(201) 794-6008

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1424131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424131200000",
    "number": "1275924904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15-01 BROADWAY STE 20",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074106003",
            "telephone_number": "847-275-3633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15-01 BROADWAY STE 20",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074106003",
            "telephone_number": "847-275-3633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH JERSEY ORTHOPEDIC SPORTS TRAUMA INSTITUTE E LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-17",
        "last_updated": "2015-02-17",
        "status": "A",
        "authorized_official_last_name": "GREENBLUM",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "201-794-6008"
    },
    "taxonomies": [
        {
            "code": "207XS0114X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "NJ",
            "license": "25MA05165000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Reconstructive Orthopaedic Surgery Physician in Fair Lawn, NJ
• Providers in Fair Lawn, NJ by specialty
• Adult Reconstructive Orthopaedic Surgery Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2015; 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.