Organization
GARDEN STATE ORTHOPAEDIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LOUIS J. HABERMAN C.P.O. (PRESIDENT)
(973) 538-4948
Entity
Organization
Contact information
Practice address
95 MOUNT KEMBLE AVE, ANNEX BUILDING, MORRISTOWN, NJ 07960-5155
(973) 538-4948
(973) 605-8481
Mailing address
95 MOUNT KEMBLE AVE, ANNEX BUILDING, MORRISTOWN, NJ 07960-5155
(973) 538-4948
(973) 605-8481
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
#36877
AETNA PROVIDER NUMBER
NJ
05
—
3897206-01
—
NJ
Enumeration date
08/15/2005
Last updated
08/17/2018
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