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General NPI Number Information
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NPI Number | 1295510352
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Entity Type | Organization
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Legal Business Name | JERSEY JOINT SPINE & REGEN, LLC
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Dates
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Enumeration Date | 08/28/2023
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Last Update Date | 05/06/2024
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Provider Practice Location Address
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Address Line | 12 US HIGHWAY 9 STE 108
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City | MORGANVILLE
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State | NJ
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Zip | 07751-1575
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Country | US
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Telephone | 732-858-6638
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Fax | 732-858-6638
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Provider Business Mailing Address
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Address Line | 214 SANBORN AVE
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City | POINT PLEASANT BEACH
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State | NJ
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Zip | 08742-2660
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Country | US
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Telephone | 732-858-6638
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Fax | 732-858-6638
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Authorized Official
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Title or Position | OWNER
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Name | MR. GERALD M VERNON
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Credential | DO
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Telephone | 609-643-0894
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number |
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License Number State |
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