Healthcare Provider Details

I. General information

NPI: 1639000797
Provider Name (Legal Business Name): TRIUMPH ORTHO & SPINE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

881 ALLWOOD RD STE 2B
CLIFTON NJ
07012-1900
US

IV. Provider business mailing address

1360 CLIFTON AVE STE 92
CLIFTON NJ
07012-1453
US

V. Phone/Fax

Practice location:
  • Phone: 877-215-7246
  • Fax:
Mailing address:
  • Phone: 973-779-7361
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. EHSAN ABDESHAHIAN
Title or Position: MEMBER
Credential: MD
Phone: 405-306-0384