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General NPI Number Information
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NPI Number | 1073821989
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Entity Type | Organization
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Legal Business Name | NEW JERSEY NECK & BACK INSTITUTE PC
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Dates
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Enumeration Date | 09/14/2010
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Last Update Date | 09/14/2010
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Provider Practice Location Address
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Address Line | 3131 PRINCETON PIKE BUILDING 6, SUITE 106
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City | LAWRENCEVILLE
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State | NJ
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Zip | 08648-2201
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Country | US
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Telephone | 609-896-0020
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Fax | 609-896-0041
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Provider Business Mailing Address
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Address Line | 3131 PRINCETON PIKE BUILDING 6, SUITE 106
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City | LAWRENCEVILLE
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State | NJ
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Zip | 08648-2201
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Country | US
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Telephone | 609-896-0020
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Fax | 609-896-0041
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Authorized Official
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Title or Position | OWNER
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Name | SANDRO LAROCCA
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Credential | MD
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Telephone | 609-896-0020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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