Organization Active NPI

North Jersey Orthopedic Sports Trauma Institute E LLC

  • Adult Reconstructive Orthopaedic Surgery Physician
  • Fair Lawn, NJ
National Provider Identifier
1275924904
Registry record updated Feb 17, 2015
On this page

Key facts

NPPES NPI Registry
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
Last updated
Feb 17, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2015

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

Authorized official

Name
Robert GreenblumNPI 1073575551
Title
MD
Phone
(201) 794-6008

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Reconstructive Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207XS0114X 25MA05165000 NJ Primary

Addresses

Primary practice location

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

Mailing address

15-01 Broadway Ste 20
Fair Lawn, NJ 07410-6003
Phone (847) 275-3633

National Provider Directory

National Provider Directory

Locations

15-01 Broadway
Ste 20
Fair Lawn, NJ 07410
Phone (201) 794-6008

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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": []
}

Other providers in Fair Lawn, NJ

Sources for this page

  • 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.