Provider Demographics
NPI:1366401846
Name:ORTHOPEDIC CARE HAND CENTER
Entity type:Organization
Organization Name:ORTHOPEDIC CARE HAND CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:CHRIS
Authorized Official - Last Name:BASSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:OTR CHT
Authorized Official - Phone:201-796-6140
Mailing Address - Street 1:23-00 ROUTE 208
Mailing Address - Street 2:
Mailing Address - City:FAIRLAWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07410
Mailing Address - Country:US
Mailing Address - Phone:201-796-6140
Mailing Address - Fax:201-796-6372
Practice Address - Street 1:23-00 ROUTE 208
Practice Address - Street 2:
Practice Address - City:FAIRLAWN
Practice Address - State:NJ
Practice Address - Zip Code:07410
Practice Address - Country:US
Practice Address - Phone:201-796-6140
Practice Address - Fax:201-796-6372
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-22
Last Update Date:2007-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TB00099100225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1117650001Medicare NSC
067997Medicare ID - Type Unspecified