Provider Demographics
NPI:1306667514
Name:LONGMONT ORTHOPEDICS PC
Entity type:Organization
Organization Name:LONGMONT ORTHOPEDICS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:SUNIL
Authorized Official - Middle Name:S
Authorized Official - Last Name:JANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-757-3621
Mailing Address - Street 1:5155 EAGAN CIR
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80503-8558
Mailing Address - Country:US
Mailing Address - Phone:720-239-2142
Mailing Address - Fax:
Practice Address - Street 1:600 S AIRPORT RD. BLDG C
Practice Address - Street 2:SUITE D
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80503
Practice Address - Country:US
Practice Address - Phone:720-239-2142
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-21
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty