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General NPI Number Information
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NPI Number | 1518632199
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Entity Type | Organization
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Legal Business Name | I SPINE, PC
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Dates
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Enumeration Date | 08/16/2021
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Last Update Date | 03/03/2022
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Provider Practice Location Address
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Address Line | 1389 W MAIN ST STE 123
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City | WATERBURY
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State | CT
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Zip | 06708-3104
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Country | US
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Telephone | 203-755-5555
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Fax | 203-819-7739
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Provider Business Mailing Address
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Address Line | 60 PRINZ CT
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City | CHESHIRE
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State | CT
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Zip | 06410-2972
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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 AND PHYSICIAN
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Name | TAMAR GHALY
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Credential | MD
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Telephone | 917-526-7039
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number |
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License Number State |
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