Provider Demographics
NPI:1568493393
Name:SOUTH MOUNTAIN ORTHOPAEDIC ASSOCIATES LLC
Entity type:Organization
Organization Name:SOUTH MOUNTAIN ORTHOPAEDIC ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:V PRES
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:E
Authorized Official - Last Name:HELBIG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-762-8344
Mailing Address - Street 1:61 1ST ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07079-1900
Mailing Address - Country:US
Mailing Address - Phone:973-762-8344
Mailing Address - Fax:973-762-1626
Practice Address - Street 1:61 1ST ST
Practice Address - Street 2:
Practice Address - City:SOUTH ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07079-1900
Practice Address - Country:US
Practice Address - Phone:973-762-8344
Practice Address - Fax:973-762-1626
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-06
Last Update Date:2010-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2675706Medicaid
NJ076472Medicare ID - Type Unspecified
NJ076472Medicare UPIN