# RUTGERS, THE STATE UNIVERSITY OF NEW JERSEY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Rutgers University Sports Medicine
- **Organization subpart:** No

## Provider details

- **NPI number:** 1710117437
- **Authorized official:** MELANIE JEITNER (ATHLETIC INSURANCE COORDINATOR)
- **Authorized official phone:** (732) 445-6258

## Contact information

- **Practice address:** 1 SCARLET KNIGHT WAY, PISCATAWAY, NJ 08854-8069
- **Practice address phone:** (732) 445-6258
- **Practice address fax:** (732) 445-2780
- **Mailing address:** PO BOX 168007, IRVING, TX 75016-8007
- **Mailing address phone:** (866) 890-6390
- **Mailing address fax:** (325) 437-8390

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QS0010X | Sports Medicine (Family Medicine) Physician | — | NULL | Yes |
| 207QS0010X | Sports Medicine (Family Medicine) Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/15/2009
- **Last updated:** 07/15/2009