| Suburban Orthopaedic Medical Center, Llc | |
|
554 Bloomfield Ave, Newark, NJ 07107-1338 | |
| (973) 483-2277 | |
| (973) 483-4577 |
| Full Name | Suburban Orthopaedic Medical Center, Llc |
|---|---|
| Type | Facility |
| Speciality | Orthopaedic Surgery |
| Location | 554 Bloomfield Ave, Newark, New Jersey |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861603748 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | (* (Not Available)) | Secondary |
| 207X00000X | Orthopaedic Surgery | MAO26807 (New Jersey) | Primary |
| Provider Name | Natasha Fuksina |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053398065 PECOS PAC ID: 7315932258 Enrollment ID: I20051227000012 |
| Provider Name | Cayetano Mark Tuason |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1609805746 PECOS PAC ID: 9739106287 Enrollment ID: I20060110001046 |
| Provider Name | Michael Cunningham |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1033256243 PECOS PAC ID: 2466547377 Enrollment ID: I20090617000498 |
| Provider Name | Franco Rizzolo |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1861568537 PECOS PAC ID: 2961533781 Enrollment ID: I20100623000477 |
| Provider Name | Jeffrey J. Fossati |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1093875015 PECOS PAC ID: 0345412425 Enrollment ID: I20111014000154 |
| Provider Name | Andrew Carollo |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1922189828 PECOS PAC ID: 9032110317 Enrollment ID: I20111110000061 |
| Provider Name | Anthony J Blake |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1568689263 PECOS PAC ID: 0143492751 Enrollment ID: I20151006002602 |
| Provider Name | John B Howe |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1689745150 PECOS PAC ID: 8527364314 Enrollment ID: I20160303001583 |
| Mailing Address | Practice Location Address |
|---|---|
| Suburban Orthopaedic Medical Center, Llc 554 Bloomfield Ave, Newark, NJ 07107-1338 Ph: (973) 483-2277 | Suburban Orthopaedic Medical Center, Llc 554 Bloomfield Ave, Newark, NJ 07107-1338 Ph: (973) 483-2277 |