PRINCETON BRAIN SPINE AND SPORTS MEDICINE, LLC (NPI# 1366002651) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366002651 |
| Entity Type | Organization |
| Organization Name | PRINCETON BRAIN SPINE AND SPORTS MEDICINE, LLC |
| Practice Address |
558 Lawrence Square Blvd S Lawrenceville NJ 08648-2674 |
| Practice Telephone | 6099219001 |
| Mailing Telephone | 6095856100 |
| Enumeration Date | 2019-06-18 |
| Last Update Date | 2019-08-07 |
| Authorized Official Name | GREGORY QUILLE (PRESIDENT) |
| Authorized Official Telephone | 6095856100 |
| Authorized Official Credential | DC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | Chiropractic Providers |
| Other Name | Type Code |
|---|---|
| Princeton Brain, Spine & Sports Medicine | Doing Business As Name - Organization |
| Street Address |
558 LAWRENCE SQUARE BLVD S |
| City | LAWRENCEVILLE |
| State | NJ |
| Zip Code | 08648-2674 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336763531 | Medlife Diagnostic Laboratories | Clinical Medical Laboratory | 1717 Brunswick Ave, Lawrence Twp, NJ 08648 | 2020-06-03 |
| 1770137226 | Andrew Corato | Specialist/Technologist | Rider Sports Medicine 2083 Lawrenceville Road, Lawrenceville, NJ 08648 | 2019-08-01 |
| 1457832149 | St. Mary's Assisted Living | Assisted Living Facility | One Bishops' Drive, Lawrenceville, NJ 08648 | 2018-08-22 |
| 1255832341 | Alma Garcia | Social Worker | 9 Gordon Avenue, Lawrenceville, NJ 08648 | 2018-02-23 |
| 1548760804 | Lawrence Spine & Wellness Pa | Chiropractor | 558 Lawrence Square Blvd South, Lawrenceville, NJ 08648 | 2018-02-13 |
| 1982134722 | Cindy Johnson | Counselor | 8433 Town Court North, Lawrenceville, NJ 08648 | 2017-06-14 |
| 1306372719 | Adapt Performance and Rehab | Clinic/Center | 1080 Spruce Street, Suite A, Lawrence Township, NJ 08648 | 2017-05-04 |
| 1780123588 | Feliks Shtindler Md PC | Internal Medicine | 3450 Princeton Pike, Suite 120, Lawrenceville, NJ 08648 | 2017-02-14 |
| 1295272995 | Favorite Dentist, LLC | Dentist | 3100 Princeton Pk., Bldg 2 1st Floor, Lawrenceville, NJ 08648 | 2017-01-20 |
| 1508241803 | Eden Autism Services. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 21302 Cedar Court, Lawrenceville, NJ 08648 | 2015-07-28 |
| Find all providers in zip 08648 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689290942 | Shelby Kemp | Chiropractor | 455 Grayson Hwy Ste 107, Lawrenceville, GA 30046-7159 | 2020-06-23 |
| 1306499785 | Bryan Acosta | Chiropractor | 471 Scenic Hwy South, Lawrenceville, GA 30046 | 2019-07-24 |
| 1205491313 | Youngoh Kim | Chiropractor | 1770 Rutland Pass Dr, Lawrenceville, GA 30045-3726 | 2019-05-03 |
| 1568934719 | Renee Christine Robus | Chiropractor | 136 Franklin Corner Rd Ste 110, Lawrenceville, NJ 08648-2586 | 2018-12-28 |
| 1174005284 | Rita Patel | Chiropractor | 2709 Still Farms Pl, Lawrenceville, GA 30043-6156 | 2018-09-05 |
| 1548760804 | Lawrence Spine & Wellness Pa | Chiropractor | 558 Lawrence Square Blvd South, Lawrenceville, NJ 08648 | 2018-02-13 |
| 1750801205 | Revive Medical Center, LLC | Chiropractor | 753 Old Norcross Rd Ste A, Lawrenceville, GA 30046-4312 | 2017-06-26 |
| 1043602170 | Tn Chiropractic Clinic, LLC | Chiropractor | 1848 Old Norcross Rd Ste A400, Lawrenceville, GA 30044-2311 | 2015-02-26 |
| 1386045706 | Bruce R. Brilliantine | Chiropractor | 2 Princess Road, Suiet #2, Lawrenceville, NJ 08648 | 2014-09-05 |
| 1588079818 | Sports Doc LLC | Chiropractor | 2505 Newpoint Pkwy, Ste 200, Lawrenceville, GA 30043-6003 | 2014-06-25 |
| Find all providers in LAWRENCEVILLE | ||||
| City | LAWRENCEVILLE |
| Zip Code | 08648 |
Please comment or provide details below to improve the information on PRINCETON BRAIN SPINE AND SPORTS MEDICINE, LLC.
| 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.