Healthcare Provider Details

I. General information

NPI: 1194539965
Provider Name (Legal Business Name): COMPREHENSIVE SPINAL SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2025
Last Update Date: 02/03/2025
Certification Date: 01/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 S BRYN MAWR AVE
BRYN MAWR PA
19010-3121
US

IV. Provider business mailing address

224 N BOWMAN AVE
MERION STATION PA
19066-1222
US

V. Phone/Fax

Practice location:
  • Phone: 484-337-3000
  • Fax:
Mailing address:
  • Phone: 732-735-8874
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number
License Number State

VIII. Authorized Official

Name: IAN DAVID KAYE
Title or Position: SURGEON
Credential: MD
Phone: 732-735-8874