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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

PRO FORM SPORTS MEDICINE AND WELLNESS ASSOCIATES

Active Organization

Sports Medicine (EM) · RUTHERFORD, NJ

Registration Details

NPI Number
1235432972
Provider Type
Organization
NPI Issued
Dec 20, 2010 (15.337397950965 yrs)
Last Updated
Dec 20, 2010
License
25MA08835000 (NJ)

Practice Information

Address
201 ROUTE 17
11TH FLOOR
RUTHERFORD, NJ, 070702574
Browse NJ providers · Browse ZIP 07070
Phone
2015498846
Fax
2015498839
Primary Specialty
Sports Medicine (EM)
207PS0010X
Data sourced from the NPPES National Provider Identifier registry. Healthcare organizations registered in NPPES are assigned an NPI number for use in insurance billing and claims. This information is for informational purposes only. For official verification, use the NPPES NPI Registry.