SPINE INSTITUTE OF NEW JERSEY LLC


Address: 375 Broadway, Suite 1, Paterson, NJ 07501-2294
Phone: 9739251881

SPINE INSTITUTE OF NEW JERSEY LLC (NPI# 1013465947) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1013465947
Entity Type Organization
Organization Name SPINE INSTITUTE OF NEW JERSEY LLC
Practice Address 375 Broadway
Suite 1
Paterson
NJ 07501-2294
Practice Telephone 9739251881
Practice Fax Number 9739251884
Mailing Telephone 9739251881
Mailing Fax Number 9739251884
Enumeration Date 2016-09-20
Last Update Date 2016-09-20
Authorized Official Name DR. DAVID G HARRIS (MANAGING ADMINISTRATOR)
Authorized Official Telephone 9739251881
Authorized Official Credential DC
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QM2500X Clinic/Center
Specialization: Medical Specialty
38MC00508400 NJ Ambulatory Health Care Facilities

Office Location

Street Address 375 BROADWAY
SUITE 1
City PATERSON
State NJ
Zip Code 07501-2294

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1639508187 Maryanne Bolton Nurse Practitioner 393 Main Street, Paterson, NJ 07501 2013-11-05
1699058545 Martha Quecan-garcia Pharmacist 639 East 18 Th St, Paterson, NJ 07501 2011-09-27
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Taxonomy Information

Taxonomy Code 261QM2500X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Medical Specialty

Taxonomy Definition

An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).
Notes: [7/1/2003: new]

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1346783602 Best Family Doctor PC Clinic/Center 295 Broadway, Paterson, NJ 07501-2000 2016-11-18
1487864591 Main Chiro-care Center PC Clinic/Center 1029 Main St, Paterson, NJ 07503-2200 2007-05-23

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Competitor

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City PATERSON
Zip Code 07501

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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