Active Orthopaedics and Sports Medicine, PA
Organization Active NPI Sports Medicine (Orthopaedic Surgery) Physician · Hackensack, NJ
NPI 1659326569 · NPPES record last updated Dec 16, 2008
Key facts
- NPI
- 1659326569
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X
- License
- 25MA5362900 (NJ)
- Legal business name
- ACTIVE ORTHOPAEDICS AND SPORTS MEDICINE, PA
- Practice address
- 25 Prospect Ave
Hackensack, NJ 07601-1960 - Phone
- (201) 343-2277
- Fax
- (201) 343-7410
- NPI assigned
- May 23, 2006
- Organization subpart
- No
Authorized official
- Name
- Michael Lee Gross, M.D.
- Title
- President/Owner
- Phone
- (201) 358-0707
National Provider Directory
Locations
390 Old Hook Rd
Westwood, NJ 07675
Phone (201) 358-0707
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Medicine (Orthopaedic Surgery) Physician |
207XX0005X | 25MA5362900 | NJ | Yes |
| Sports Medicine (Orthopaedic Surgery) Physician |
207XX0005X | 25MA08256500 | NJ |
Addresses
Primary practice location
25 Prospect Ave
Hackensack, NJ 07601-1960
Mailing address
390 Old Hook Rd
Westwood, NJ 07675-2616
Phone (201) 358-0707
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CK8050 | Other | NJ | RAILROAD MEDICARE |
Other providers in Hackensack, NJ
- Gabriella Acoury
- Acousticon Haskill Inc
- Acousticon Haskill Inc.
- Joseph F Acquaviva
- Active Center for Health and Wellness
- Active Orthopedic Specialists, LLC
- Active Orthopedics & Sports Medicine LLC
- Active Orthopedics and Sports Medicine, LLC
- Charles Andrew Adams Jr.
- Lawrence George Adelsohn
All providers in Hackensack, NJ · Sports Medicine (Orthopaedic Surgery) Physician in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 16, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.