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General NPI Number Information
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NPI Number | 1093662793
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Entity Type | Organization
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Legal Business Name | JERSEY SPINE & ORTHOPEDICS PC
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Dates
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Enumeration Date | 03/12/2026
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Last Update Date | 03/12/2026
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Provider Practice Location Address
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Address Line | 3540 JOHN F KENNEDY BLVD
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City | JERSEY CITY
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State | NJ
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Zip | 07307-3450
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Country | US
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Telephone | 301-380-1332
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Fax |
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Provider Business Mailing Address
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Address Line | 6 AVE AT PORT IMPERIAL APT 6211
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City | WEST NEW YORK
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State | NJ
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Zip | 07093-8333
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. NANDAN SHAH
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Credential | MD
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Telephone | 630-854-7066
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XS0114X
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Taxonomy Name | Adult Reconstructive Orthopaedic Surgery Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207XX0801X
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Taxonomy Name | Orthopaedic Trauma Physician
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License Number |
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License Number State |
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Taxonomy #4
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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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