Provider Demographics
NPI:1104558980
Name:BIORESTORE OF ORADELL
Entity type:Organization
Organization Name:BIORESTORE OF ORADELL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANGELO
Authorized Official - Middle Name:
Authorized Official - Last Name:CAPRIO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-376-6100
Mailing Address - Street 1:800 KINDERKAMACK RD
Mailing Address - Street 2:
Mailing Address - City:ORADELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07649-1534
Mailing Address - Country:US
Mailing Address - Phone:203-309-9378
Mailing Address - Fax:914-470-5056
Practice Address - Street 1:800 KINDERKAMACK RD
Practice Address - Street 2:
Practice Address - City:ORADELL
Practice Address - State:NJ
Practice Address - Zip Code:07649-1534
Practice Address - Country:US
Practice Address - Phone:203-309-9378
Practice Address - Fax:914-470-5056
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-29
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty