Healthcare Provider Details

I. General information

NPI: 1982174769
Provider Name (Legal Business Name): SPINE & SPORTS MEDICINE OF HAMILTON LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2018
Last Update Date: 12/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 CABOT DRIVE SUITE A
HAMILTON NJ
08691
US

IV. Provider business mailing address

104 CABOT DRIVE SUITE A
HAMILTON NJ
08691
US

V. Phone/Fax

Practice location:
  • Phone: 732-521-9222
  • Fax:
Mailing address:
  • Phone: 609-528-4417
  • 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

VIII. Authorized Official

Name: DR. ANTHONY ALFIERI
Title or Position: OWNER
Credential:
Phone: 609-528-4417