Healthcare Provider Details

I. General information

NPI: 1689940900
Provider Name (Legal Business Name): MADISON SPINE LIMITED PARTNERSHIP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2012
Last Update Date: 09/25/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

219 RICHMOND AVE
NEW MILFORD NJ
07646-2517
US

IV. Provider business mailing address

1300 W SAM HOUSTON PKWY S SUITE 300
HOUSTON TX
77042-2447
US

V. Phone/Fax

Practice location:
  • Phone: 201-907-3150
  • Fax: 201-907-3155
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: RICHARD BINSTEIN
Title or Position: VP, AUTHORIZED OFFICIAL
Credential:
Phone: 713-297-7000