PREMIER SPINE AND WELLNESS INC (NPI# 1407399553) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407399553 |
| Entity Type | Organization |
| Organization Name | PREMIER SPINE AND WELLNESS INC |
| Other Organization Name | PREMIER SPINE AND WELLNESS INC |
| Practice Address |
26 Holly Dr Medford NJ 08055-8843 |
| Mailing Address |
2070 Springdale Rd Ste 200 Cherry Hill NJ 08003-2043 |
| Practice Telephone | 6096264008 |
| Mailing Telephone | 6096264008 |
| Enumeration Date | 2016-11-22 |
| Last Update Date | 2016-11-22 |
| Authorized Official Name | DR. MANAL MENA (OWNER) |
| Authorized Official Telephone | 6096264008 |
| Authorized Official Credential | D.C. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QH0100X |
Clinic/Center Specialization: Health Service |
38MC00711800 | NJ | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Premier Spine and Wellness Inc | Other Name - Individual/Organization |
| Street Address |
26 HOLLY DR |
| City | MEDFORD |
| State | NJ |
| Zip Code | 08055-8843 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215406459 | Natalia Eltabaa | Nurse Practitioner | 143b Atsion Rd, Medford, NJ 08055 | 2018-11-16 |
| 1922574326 | Emily G Wilkins | Psychiatry & Neurology | 239 Taunton, A-2, Medford, NJ 08055 | 2018-10-23 |
| 1508348863 | Gerald D Mingin Jr. | Psychologist | 135 Eayrestown Rd. Suite A, Southampton, NJ 08055 | 2018-09-04 |
| 1316465750 | Gabriella Marie Francis | Specialist/Technologist | 133 Apache Trail, Medford Lakes, NJ 08055 | 2017-09-06 |
| 1265968572 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 609 Eugenia, Medford, NJ 08055 | 2017-05-05 |
| 1326574690 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1503 Cedar Dr, Medford, NJ 08055 | 2017-05-05 |
| 1780110007 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1610 Cedar Dr, Medford, NJ 08055 | 2017-05-05 |
| 1902332216 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1909 Cedar Dr, Medford, NJ 08055 | 2017-05-05 |
| 1083140396 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 503 Eugenia Dr, Medford, NJ 08055 | 2017-05-05 |
| 1457887762 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 905 Eugenia Dr, Medford, NJ 08055 | 2017-05-05 |
| Find all providers in zip 08055 | ||||
| Taxonomy Code | 261QH0100X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Health Service |
| Definition to come... |
| Notes: [7/1/2006: modified title] |
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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.