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General NPI Number Information
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NPI Number | 1386964286
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Entity Type | Organization
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Legal Business Name | ATLANTIC SPINE AND JOINT INSTITUTE
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Dates
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Enumeration Date | 06/03/2010
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Last Update Date | 07/15/2011
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Provider Practice Location Address
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Address Line | 654 W CUTHBERT BLVD
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City | HADDON TOWNSHIP
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State | NJ
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Zip | 08108-3642
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Country | US
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Telephone | 856-854-3472
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Fax | 856-854-9192
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Provider Business Mailing Address
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Address Line | 654 W. CUTHBERT BLVD
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City | HADDON TOWNSHIP
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State | NJ
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Zip | 08108
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Country | US
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Telephone | 856-854-3472
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Fax | 856-854-9192
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Authorized Official
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Title or Position | DIRECTOR OF MEDICAL SERVICES
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Name | DR. ROBERT CLAUDE MCGRATH
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Credential | D.O.
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Telephone | 856-854-3472
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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 | 25MB08697100
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License Number State | NJ
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