Organization
SPECIALTY ORTHOPAEDICS OF NEW JERSEY, PA
Active
Other names
EDWARD B SELF JR MD FACS PA
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID P RUDMAN M.D. (PRESIDENT)
(201) 447-1188
Entity
Organization
Contact information
Practice address
1124 E RIDGEWOOD AVE, 201, RIDGEWOOD, NJ 07450-3915
(201) 447-1188
(201) 447-8935
Mailing address
1124 E RIDGEWOOD AVE, 201, RIDGEWOOD, NJ 07450-3915
(201) 447-1188
(201) 447-8935
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
25MA07771200
NJ
174400000X
Specialist
Primary
MA33233
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
085563
SPECIALTY ORTHOPAEDICS
NJ
Enumeration date
04/27/2006
Last updated
10/07/2011
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