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General NPI Number Information
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NPI Number | 1184948846
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Entity Type | Organization
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Legal Business Name | ELMWOOD PARK SPINE CARE
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Dates
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Enumeration Date | 03/23/2010
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Last Update Date | 03/23/2010
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Provider Practice Location Address
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Address Line | 554 BOULEVARD
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City | ELMWOOD PARK
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State | NJ
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Zip | 07407-2031
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Country | US
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Telephone | 201-797-4500
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Fax | 201-797-8005
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Provider Business Mailing Address
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Address Line | 62 WOODWARD LN
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City | BASKING RIDGE
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State | NJ
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Zip | 07920-2723
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Country | US
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Telephone | 781-710-3843
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Fax | 908-647-3293
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ARVINDER SINGH DHILLON
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Credential | M.D.
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Telephone | 781-710-3843
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | 25MA08404400
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License Number State | NJ
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