JEFFERSON PROSTHETIC & ORTHOTIC COMPANY, INC. (NPI# 1609089523) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609089523 |
| Entity Type | Organization |
| Organization Name | JEFFERSON PROSTHETIC & ORTHOTIC COMPANY, INC. |
| Practice Address |
120 Prospect St South Orange NJ 07079-2103 |
| Practice Telephone | 9737620780 |
| Practice Fax Number | 9737621480 |
| Mailing Telephone | 9737620780 |
| Mailing Fax Number | 9737621480 |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2011-10-05 |
| Authorized Official Name | MR. SIMON C. W. CHANG (PRESIDENT) |
| Authorized Official Telephone | 9737620780 |
| Authorized Official Credential | C.P.O. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 335E00000X | Prosthetic/Orthotic Supplier | 45PO00002400 | NJ | Suppliers |
| Street Address |
120 PROSPECT ST |
| City | SOUTH ORANGE |
| State | NJ |
| Zip Code | 07079-2103 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437676848 | Kidzdoc Md Pediatrics LLC | Pediatrics | 120 Prospect St, South Orange, NJ 07079-2103 | 2017-08-25 |
| 1043397953 | Marion Patricia Houghton | Marriage & Family Therapist | 120 Prospect St, Suite D, South Orange, NJ 07079-2103 | 2006-11-01 |
| 1649236407 | Dawn Maurine Cardwell | Pediatrics | 120 Prospect St, Suite 1a, South Orange, NJ 07079-2112 | 2006-04-21 |
| 1346232964 | Judith C Hugh-goffe | Pediatrics | 120 Prospect St, South Orange, NJ 07079-2103 | 2005-08-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255946216 | Melissa Marie Johnson | Counselor | 9 Vose Avenue, South Orange, NJ 07079 | 2020-09-15 |
| 1730663493 | Private Quarters Hair Salon LLC | Prosthetic/Orthotic Supplier | 12 Academy Street, South Orange, NJ 07079 | 2018-09-19 |
| 1457731085 | Jespy House Inc. | Day Training, Developmentally Disabled Services | 343 Academy Street, South Orange, NJ 07079 | 2015-06-09 |
| 1760876460 | Dianne Marie Aguero-trotter | Psychologist | 400 South Orange Ave, South Orange, NJ 07079 | 2015-03-20 |
| 1679815922 | Beth L Sosin | Obstetrics & Gynecology | South Orange Ob/gyn & Infertility Group, 106 Valley Street, Ramp Entrance, South Orange, NJ 07079 | 2013-03-25 |
| 1790061745 | Obianuju Rita Mbamalu | Dentist | 71 Valley St Ste 100, South Orange, NJ 07079 | 2011-10-21 |
| 1669765061 | Aba 4 U | Behavioral Analyst | 4 South Orange Avenue Box 189, South Orange, NJ 07079 | 2011-05-18 |
| 1598903882 | Guiding Hands Pediatrics | Pediatrics | 179 Irvington Avenue, South Orange, NJ 07079 | 2009-01-26 |
| 1417161647 | Rosalyn Myrna Shapiro | Counselor | 346 Harding Drive, So Orange, NJ 07079 | 2007-05-09 |
| 1821200403 | Donald Raymond Reeves Jr. | Psychiatry & Neurology | 112 Raymond Avenue, South Orang, NJ 07079 | 2007-05-04 |
| Find all providers in zip 07079 | ||||
| Taxonomy Code | 335E00000X |
| Grouping | Suppliers |
| Classification | Prosthetic/Orthotic Supplier |
| An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition. |
| Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730663493 | Private Quarters Hair Salon LLC | Prosthetic/Orthotic Supplier | 12 Academy Street, South Orange, NJ 07079 | 2018-09-19 |
| 1013539550 | Shantella Rios | Prosthetic/Orthotic Supplier | 12 Academy St, South Orange, NJ 07079-1906 | 2020-05-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902405673 | Harry J. Lawall & Son, Inc | Prosthetic/Orthotic Supplier | 1973 Highway 34 Harry J. Lawall & Son Inc., Wall, NJ 07719-0007 | 2020-10-22 |
| 1639789340 | Shantise Michelle Cranial Prosthesis | Prosthetic/Orthotic Supplier | 2816 Morris Ave Ste 20b, Union, NJ 07083-4849 | 2020-08-06 |
| 1477185015 | Cranial Technologies, Inc. | Prosthetic/Orthotic Supplier | 1810 Chapel Ave W Ste 100, Cherry Hill, NJ 08002-4606 | 2020-02-11 |
| 1568020311 | Vine Beauty Supply | Prosthetic/Orthotic Supplier | 615 Rahway Ave, Woodbridge, NJ 07095-3437 | 2019-06-05 |
| 1871066142 | Hair Chalet Multicultural Hair Designers | Prosthetic/Orthotic Supplier | 1632 Springfield Ave, Maplewood, NJ 07040-2414 | 2019-01-09 |
| 1194291575 | Philadelphia Orthotics and Prosthetics, Inc. | Prosthetic/Orthotic Supplier | 709 Somerdale Road, Voorhees, NJ 08043-1313 | 2018-10-23 |
| 1053898379 | Boston Brace International Inc. | Prosthetic/Orthotic Supplier | 5 Franklin Ave Ste 407, Belleville, NJ 07109-3565 | 2018-07-20 |
| 1104315639 | Next Step Orthopaedics, Inc. | Prosthetic/Orthotic Supplier | 26 Madison Ave Ste 5, Morristown, NJ 07960-7366 | 2018-05-10 |
| 1720580988 | Boston Brace International Inc. | Prosthetic/Orthotic Supplier | 964 Kinderkamack Rd, River Edge, NJ 07661-2331 | 2018-03-05 |
| 1932612660 | Rothman Institute of New Jersey, P.a. | Prosthetic/Orthotic Supplier | 106 South Dennis Road, Building 200, Suite 200, Cape May Court House, NJ 08210 | 2017-11-16 |
| Find all providers with the same taxonomy | ||||
| City | SOUTH ORANGE |
| Zip Code | 07079 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.