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General NPI Number Information
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NPI Number | 1225109572
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Entity Type | Organization
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Legal Business Name | UNIVERSITY SPINE ASSOCIATES P.A
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Dates
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Enumeration Date | 11/10/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 256 BUNN DR SUITE 3B
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City | PRINCETON
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State | NJ
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Zip | 08540-2859
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Country | US
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Telephone | 609-924-8060
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Fax |
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Provider Business Mailing Address
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Address Line | 256 BUNN DR SUITE 3B
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City | PRINCETON
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State | NJ
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Zip | 08540-2859
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Country | US
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Telephone | 609-924-8060
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. HAIM DROR BLECHER
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Credential | M.D
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Telephone | 609-924-8060
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MA69557
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License Number State | NJ
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