Provider Demographics
NPI:1891181814
Name:RICHARD LEBOVICZ ORTHO LLC
Entity type:Organization
Organization Name:RICHARD LEBOVICZ ORTHO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:S
Authorized Official - Last Name:LEBOVICZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-756-9500
Mailing Address - Street 1:908 OAK TREE AVE
Mailing Address - Street 2:SUITE E
Mailing Address - City:SOUTH PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07080-5100
Mailing Address - Country:US
Mailing Address - Phone:908-756-9500
Mailing Address - Fax:
Practice Address - Street 1:908 OAK TREE AVE
Practice Address - Street 2:SUITE E
Practice Address - City:SOUTH PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07080-5100
Practice Address - Country:US
Practice Address - Phone:908-756-9500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-07
Last Update Date:2015-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ520360Medicare UPIN