Healthcare Provider Details

I. General information

NPI: 1235061573
Provider Name (Legal Business Name): BRAIN AND SPINE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 EXCHANGE PL STE 503
JERSEY CITY NJ
07302-3914
US

IV. Provider business mailing address

15 EXCHANGE PL STE 503
JERSEY CITY NJ
07302-3914
US

V. Phone/Fax

Practice location:
  • Phone: 551-233-2300
  • Fax: 212-404-8069
Mailing address:
  • Phone: 551-233-2300
  • Fax: 212-404-8069

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number
License Number State

VIII. Authorized Official

Name: ORYAN BARUCH
Title or Position: PRESIDENT
Credential: DO
Phone: 551-233-2300