Provider Demographics
NPI:1992709760
Name:BORETZ, ROBERT STEPHEN (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:STEPHEN
Last Name:BORETZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:762 US HIGHWAY 202/206
Mailing Address - Street 2:
Mailing Address - City:BRIDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:08807-1773
Mailing Address - Country:US
Mailing Address - Phone:908-429-7600
Mailing Address - Fax:908-429-7960
Practice Address - Street 1:762 US HIGHWAY 202/206
Practice Address - Street 2:
Practice Address - City:BRIDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:08807-1773
Practice Address - Country:US
Practice Address - Phone:908-429-7600
Practice Address - Fax:908-429-7960
Is Sole Proprietor?:No
Enumeration Date:2005-06-09
Last Update Date:2010-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07211900207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ841666216OtherTID
NJ088427Medicare PIN
NJH41678Medicare UPIN