MEDICARE: LINDEN SPORT AND SPINE

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	171100000X	Acupuncturist
2	225100000X	Physical Therapist
3	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1811404239
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LINDEN SPORT AND SPINE

Provider Business Mailing Address
First Line	:	201 S PARK AVE
Second Line	:
City	:	LINDEN
State	:	NJ
Zip	:	07036-1101
Country	:	US
Telephone Number	:	201-326-4833
Fax Number	:

Provider Business Practice Location Address
First Line	:	201 S PARK AVE
Second Line	:
City	:	LINDEN
State	:	NJ
Zip	:	07036-1101
Country	:	US
Telephone Number	:	201-326-4833
Fax Number	:

Authorized Official
Title or Position	:	BILLING MANAGER
Name	:	MS. KASHAMBA BUSBY
Credential	:
Telephone Number	:	973-392-8916

Provider Enumeration Date	:	01/08/2018
Last Update Date	:	01/08/2018

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Directions to “LINDEN SPORT AND SPINE ” Practice Location

Language	Start Address	Practice Location

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