Healthcare Provider Details

I. General information

NPI: 1457212961
Provider Name (Legal Business Name): NJ ORTHOPEDICS PAIN & SPINE CENTER PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/24/2025
Last Update Date: 11/24/2025
Certification Date: 11/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 OVERHILL RD STE 340
SCARSDALE NY
10583-5325
US

IV. Provider business mailing address

2 OVERHILL RD STE 340
SCARSDALE NY
10583-5325
US

V. Phone/Fax

Practice location:
  • Phone: 212-737-3301
  • Fax:
Mailing address:
  • Phone: 212-737-3301
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number
License Number State

VIII. Authorized Official

Name: STEPHEN J NICHOLAS
Title or Position: OWNER
Credential: MD
Phone: 212-737-3301