MEDICARE: NEW JERSEY BRAIN & SPINE PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	2081P2900X	Pain Medicine (Physical Medicine & Rehabilitation) Physician
2	2084P0005X	Neurodevelopmental Disabilities Physician
3	363AS0400X	Surgical Physician Assistant
4	207T00000X	Neurological Surgery Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1063537470	OTHER	NJ	NPI

General Provider Information

NPI Number	:	1063537470
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW JERSEY BRAIN & SPINE PC

Provider Business Mailing Address
First Line	:	650 FROM RD STE 220
Second Line	:
City	:	PARAMUS
State	:	NJ
Zip	:	07652-3551
Country	:	US
Telephone Number	:	201-342-2550
Fax Number	:	201-342-7171

Provider Business Practice Location Address
First Line	:	650 FROM RD STE 220
Second Line	:
City	:	PARAMUS
State	:	NJ
Zip	:	07652-3551
Country	:	US
Telephone Number	:	201-342-2550
Fax Number	:	201-342-7171

Authorized Official
Title or Position	:	BILLING MANAGER
Name	:	VIA A TZIAGAS
Credential	:
Telephone Number	:	201-342-2550

Provider Enumeration Date	:	03/21/2007
Last Update Date	:	01/06/2025

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Directions to “NEW JERSEY BRAIN & SPINE PC ” Practice Location

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