# PROFESSIONAL ORTHOPEDIC ASSOCIATES OF/IS SOUTHERN NJ

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1245279942
- **Authorized official:** MRS. CYNTHIA M VANCHO ASRT (PRACTICE MANAGER)
- **Authorized official phone:** (856) 547-2323

## Contact information

- **Practice address:** 17 WHITE HORSE PIKE, SUITE 1, HADDON HEIGHTS, NJ 08035
- **Practice address phone:** (856) 547-2323
- **Practice address fax:** (856) 547-7932
- **Mailing address:** 17 WHITE HORSE PIKE, SUITE 1, HADDON HEIGHTS, NJ 08035
- **Mailing address phone:** (856) 547-2323
- **Mailing address fax:** (856) 547-7932

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | 25MA03449600 | NJ | Yes |
| 207X00000X | Orthopaedic Surgery Physician | 25MA04381000 | NJ | — |

## Other

- **Enumeration date:** 06/06/2006
- **Last updated:** 10/30/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 2714108 | — | NJ |