Healthcare Provider Details

I. General information

NPI: 1497291728
Provider Name (Legal Business Name): SPINE AND HEALTH CENTER OF CLOSTER PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2017
Last Update Date: 07/07/2025
Certification Date: 07/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 VERVALEN ST
CLOSTER NJ
07624-2699
US

IV. Provider business mailing address

31 VER VALEN ST
CLOSTER NJ
07624-2699
US

V. Phone/Fax

Practice location:
  • Phone: 201-746-6577
  • Fax: 201-746-6576
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: JOCELYNN ROMAN
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 201-746-6577