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Organization

GARDEN STATE ORTHOPAEDIC ASSOCIATES, P.A.

Active
Parent organization
GARDEN STATE ORTHOPAEDIC ASSOCIATES, P.A.
Organization subpart
Yes

Provider details

NPI number
Legal business name
GARDEN STATE ORTHOPAEDIC ASSOCIATES, P.A.
Authorized official
DR. KENNETH A LEVITSKY M.D. (PRESIDENT)
(201) 791-4434
Entity
Organization

Contact information

Practice address
400 FRANKLIN TPKE, SUITE 112, MAHWAH, NJ 07430-3516
(201) 825-2266
Mailing address
28-04 BROADWAY, FAIR LAWN, NJ 07410-3913
(201) 791-4434

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
207XS0106X
Orthopaedic Hand Surgery Physician
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician

Other

Enumeration date
03/26/2012
Last updated
03/26/2012
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