Provider Demographics
NPI:1053705301
Name:TRENTON ORTHOPAEDIC GROUP, PA
Entity type:Organization
Organization Name:TRENTON ORTHOPAEDIC GROUP, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:FLETCHER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-581-2200
Mailing Address - Street 1:1225 WHITEHORSE MERCERVILLE RD
Mailing Address - Street 2:BLDG. D, SUITE 220
Mailing Address - City:MERCERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08619-3882
Mailing Address - Country:US
Mailing Address - Phone:609-581-2200
Mailing Address - Fax:
Practice Address - Street 1:1225 WHITEHORSE MERCERVILLE RD
Practice Address - Street 2:BLDG. D, SUITE 220
Practice Address - City:MERCERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08619-3882
Practice Address - Country:US
Practice Address - Phone:609-581-2200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-25
Last Update Date:2015-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00362200363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Multi-Specialty