Healthcare Provider Details

I. General information

NPI: 1508798653
Provider Name (Legal Business Name): MONMOUTH SPINE SURGERY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 W MAIN ST
FREEHOLD NJ
07728-2537
US

IV. Provider business mailing address

PO BOX 6356
FREEHOLD NJ
07728-6356
US

V. Phone/Fax

Practice location:
  • Phone: 732-813-0422
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. VIKALP JAIN
Title or Position: DIRECTOR
Credential: MD
Phone: 732-813-0422