Healthcare Provider Details

I. General information

NPI: 1235482803
Provider Name (Legal Business Name): SPINE AND HEALTH CARE CENTER OF THE PLAINFIELDS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2012
Last Update Date: 10/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 PARK AVE
PLAINFIELD NJ
07060
US

IV. Provider business mailing address

212 PARK AVE
PLAINFIELD NJ
07060-1206
US

V. Phone/Fax

Practice location:
  • Phone: 908-322-8300
  • Fax: 908-322-8311
Mailing address:
  • Phone: 908-322-8300
  • Fax: 908-322-8311

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberMC03981
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number38MC00670100
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number38MC00639000
License Number StateNJ
# 4
Primary TaxonomyN
Taxonomy Code204R00000X
TaxonomyElectrodiagnostic Medicine Physician
License Number25MB05752300
License Number StateNJ
# 5
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number25MB08610000
License Number StateNJ
# 6
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number5MA07388400
License Number StateNJ
# 7
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number25MA05863000
License Number StateNJ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. ROBERT ALBANO
Title or Position: OWNER
Credential: DC
Phone: 908-322-8300