# GARDEN STATE ORTHOPAEDICS AND SPORTS MEDICINE

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

## Provider details

- **NPI number:** 1528132289
- **Authorized official:** MARC LESLIE KAHN MD (PARTNER)
- **Authorized official phone:** (856) 616-2999

## Contact information

- **Practice address:** 455 ROUTE 70 WEST, CHERRY HILL, NJ 08002
- **Practice address phone:** (856) 616-2999
- **Practice address fax:** (856) 616-1437
- **Mailing address:** 455 ROUTE 70 WEST, CHERRY HILL, NJ 08002
- **Mailing address phone:** (856) 616-2999
- **Mailing address fax:** (856) 616-1437

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | Yes |
| 207X00000X | Orthopaedic Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/17/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 5646804 | — | NJ |
| 01 | — | CJ9376 | RR MEDICARE | — |
| 01 | — | D87253 | BLAIR MILL AMERIHEALTH | — |