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NPI Code Detail

MEDICARE: NEW JERSEY SPINE CENTER, LLC

MEDICARE: NEW JERSEY SPINE CENTER, LLC
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialistNJ

General Provider Information

NPI Number : 1881632461
Entity Type Code : Organization
Provider Name (Legal Business Name) : NEW JERSEY SPINE CENTER, LLC
Provider Business Mailing Address
First Line : 40 MAIN ST
Second Line :
City : CHATHAM
State : NJ
Zip : 07928-2431
Country : US
Telephone Number : 973-635-0800
Fax Number :
Provider Business Practice Location Address
First Line : 40 MAIN ST
Second Line :
City : CHATHAM
State : NJ
Zip : 07928-2431
Country : US
Telephone Number : 973-635-0800
Fax Number : 973-635-6254
Authorized Official
Title or Position : PRACTICE ADMINISTRATOR
Name : LISA VAN BUSKIRK
Credential :
Telephone Number : 973-635-0800
Provider Enumeration Date : 06/03/2006
Last Update Date : 07/12/2024

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Directions to “NEW JERSEY SPINE CENTER, LLC ” Practice Location

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