EXECUTIVE SPINE SURGERY (NPI# 1063968360) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063968360 |
| Entity Type | Organization |
| Organization Name | EXECUTIVE SPINE SURGERY |
| Practice Address |
657 Willow Grove St Ste 402 Hackettstown NJ 07840 |
| Mailing Address |
657 Willow Grove St Ste 402 Hackettstown NJ 07840-1868 |
| Practice Telephone | 9084525612 |
| Mailing Telephone | 9084525612 |
| Enumeration Date | 2016-08-28 |
| Last Update Date | 2016-08-28 |
| Authorized Official Name | DR. CARL J SPIVAK (NEUROSURGEON) |
| Authorized Official Telephone | 9084525612 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207T00000X | Neurological Surgery | 003005 | NY | Allopathic & Osteopathic Physicians |
| Street Address |
657 WILLOW GROVE ST STE 402 |
| City | HACKETTSTOWN |
| State | NJ |
| Zip Code | 07840 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740891894 | Amanda Kucevic | Assistant Behavior Analyst | 514 Moore Street, Hackettstown, NJ 07840 | 2020-08-12 |
| 1922571165 | Laura Montenegro | Social Worker | 3155 State Highway Route 10, Denville, NJ 07840 | 2019-01-10 |
| 1619447240 | Melissa Matturri | Pharmacist | 2045 Nj-57, Hackettstown, NJ 07840 | 2018-11-27 |
| 1164906806 | Best Choice Home Care Limited Liability Company | Home Health | 210a Goldfinch Court, Hackettstown, NJ 07840 | 2018-09-19 |
| 1003398405 | Qua Creative Kidz | Voluntary or Charitable | 707 Allen Rd, Hackettstown, NJ 07840 | 2018-08-31 |
| 1639669153 | Daniel A Jodexnis Jr. | Counselor | 112 East Ave Ste 9, Hackettstown, NJ 07840 | 2018-05-10 |
| 1649779489 | Advancing Opportunities, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 106 Possum Dr., Apt. 1, Hackettstown, NJ 07840 | 2018-02-07 |
| 1902305717 | Advancing Opportunities, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 185 Route 46 East, Apt. 1, Hackettstown, NJ 07840 | 2018-02-07 |
| 1538681473 | Sara Victoria Monk | Dietitian, Registered | 900 E Prospect Street, Hackettstown, NJ 07840 | 2017-07-12 |
| 1811426422 | Heather Mooneyhan | Nurse Practitioner | 57 U.S. 46, Suite #300, Hackettstown, NJ 07840 | 2017-06-07 |
| Find all providers in zip 07840 | ||||
| Taxonomy Code | 207T00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neurological Surgery |
| A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Neurological Surgery, 2007. http://www.abns.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Neurological Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407367576 | Outpatient Usa | Neurological Surgery | 475 Prospect Avenue, Suite 110, West Orange, NJ 07052 | 2017-10-17 |
| 1508224064 | Geoffrey Appelboom | Neurological Surgery | 703 Main St Ste A2404, Paterson, NJ 07503-2621 | 2016-01-29 |
| 1831568583 | Nj Neurosurgery, PC | Neurological Surgery | 400 Frank W Burr Blvd Ste 55, Atrium At Glenpoint, Ste 55, Teaneck, NJ 07666-6810 | 2015-09-23 |
| 1790165462 | New Neurons Neurosurgical Institute | Neurological Surgery | 32 Summit Ave, Chatham, NJ 07928 | 2015-06-08 |
| 1861893588 | Abelardo Dario Inoa | Neurological Surgery | 6 Normandy Pkwy, Morristown, NJ 07960-5716 | 2014-09-12 |
| 1669891180 | Christopher Charles Gillis | Neurological Surgery | 121 Route 36 Ste 330, West Long Branch, NJ 07764 | 2014-04-11 |
| 1912337312 | Functional Healthcare PC | Neurological Surgery | 234 Boundary Rd Unit 107, Marlboro, NJ 07746-1479 | 2013-11-21 |
| 1962849331 | David Weaver | Neurological Surgery | 725 Old Raritan Rd, Edison, NJ 08820-1021 | 2013-05-25 |
| 1831439272 | Vipin Kumar Gupta, Md Pa | Neurological Surgery | 2848 S Delsea Dr Ste 2b, Vineland, NJ 08360-7042 | 2013-02-21 |
| 1912244328 | Sanford Fineman Md LLC | Neurological Surgery | 617 Viscaya Court, Somerset, NJ 08873-6066 | 2013-01-07 |
| Find all providers with the same taxonomy | ||||
| City | HACKETTSTOWN |
| Zip Code | 07840 |
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| 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.