Healthcare Provider Details

I. General information

NPI: 1902608649
Provider Name (Legal Business Name): SYNERGY ORTHOPEDICS & SPINE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2025
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1040 MAIN ST FL 3
PATERSON NJ
07503-2212
US

IV. Provider business mailing address

1040 MAIN ST FL 3
PATERSON NJ
07503-2212
US

V. Phone/Fax

Practice location:
  • Phone: 862-208-2732
  • Fax: 973-435-8627
Mailing address:
  • Phone: 862-208-2732
  • Fax: 973-435-8627

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic 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: DR. PABLO VAZQUEZ
Title or Position: MANAGING MEMBER
Credential: MD
Phone: 973-615-5036