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General NPI Number Information
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NPI Number | 1548766165
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Entity Type | Organization
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Legal Business Name | ORTHOPAEDIC AND SPINE INSTITUTE OF NEW JERSEY, LLC
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Dates
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Enumeration Date | 04/03/2018
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Last Update Date | 10/31/2025
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Provider Practice Location Address
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Address Line | 30 W CENTURY RD STE 300
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City | PARAMUS
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State | NJ
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Zip | 07652-1435
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Country | US
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Telephone | 516-775-8602
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Fax |
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Provider Business Mailing Address
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Address Line | 30 W CENTURY RD STE 300
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City | PARAMUS
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State | NJ
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Zip | 07652-1435
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Country | US
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Telephone | 516-775-8602
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Fax | 201-793-8201
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Authorized Official
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Title or Position | OWNER
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Name | MR. BRUCE JACOBSON
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Credential |
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Telephone | 201-793-8200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | 22697
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License Number State | NJ
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