NORTHEAST SPINE & WELLNESS CENTER LLC (NPI# 1588798409) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588798409 |
| Entity Type | Organization |
| Organization Name | NORTHEAST SPINE & WELLNESS CENTER LLC |
| Practice Address |
1043 Raritan Rd Clark NJ 07066-1316 |
| Practice Telephone | 7328270800 |
| Practice Fax Number | 7328270826 |
| Mailing Telephone | 7328270800 |
| Mailing Fax Number | 7328270826 |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2016-02-25 |
| Authorized Official Name | MR. SCOT DAVID PARIS (OWNER) |
| Authorized Official Telephone | 7328270800 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | ========= | NJ | Other Service Providers |
| Street Address |
1043 RARITAN RD |
| City | CLARK |
| State | NJ |
| Zip Code | 07066-1316 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215491493 | Diane Juanita Pearson | Counselor | 49 Brant Ave Suit 3, Massler Psychological Associates, Clark, NJ 07066 | 2019-01-22 |
| 1356831754 | Christopher Dasilva | Physical Therapist | 77 Brant Avenue, Suite 101, Clark, NJ 07066 | 2018-05-11 |
| 1205350030 | City Medical of New Jersey, PC | Clinic/Center | Rarity Unit F4b, 1225 Raritan Road, Clark, NJ 07066 | 2017-08-02 |
| 1184150682 | Fyzical Therapy & Balance Center | Physical Therapist | 132-1 Westfield Ave, Clark, NJ 07066 | 2017-05-04 |
| 1164829826 | Adavanced Spine Rehabilitation LLC | Chiropractor | 1171 Old Raritan Rd, Clark, NJ 07066 | 2014-11-24 |
| 1083838395 | Stephen D Bosonac | Dentist | 979 Raritan Road, Clark, NJ 07066 | 2007-04-11 |
| 1972637965 | Jay Andrew Paris | Chiropractor | 67 Westfield Ave, Clark, NJ 07066 | 2007-03-14 |
| 1821121484 | David Kinley Jr. | Acupuncturist | 668 Raritan Rd, Clark, NJ 07066 | 2007-03-13 |
| 1811036122 | Betty C Mclendon | Psychologist | 623 Raritan Road, Clark, NJ 07066 | 2007-02-05 |
| 1710039623 | Cornerstone Physical Therapy Inc | Physical Therapist | 152 Central Ave 2nd Floor, Clark, NJ 07066 | 2007-01-18 |
| Find all providers in zip 07066 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073850327 | Jessica Lyn Colon | Specialist | 461 Westfield Ave, Clark, NJ 07066-1733 | 2013-01-07 |
| 1780889170 | Amy Q Banaga | Specialist | 26 Haliday St, Clark, NJ 07066-1833 | 2007-06-18 |
| 1942390331 | Anthony J Inverno | Specialist | 95 Westfield Ave, Clark, NJ 07066 | 2006-10-13 |
| 1235196049 | Dean Kapetanakis | Specialist | 60 Walnut Ave, Suite 150, Clark, NJ 07066-1649 | 2006-04-26 |
| 1487634846 | Joseph Edward Ochs | Specialist | 999 Raritan Rd, Box 885, Clark, NJ 07066-1757 | 2006-01-20 |
| 1386637254 | David E Wexler | Specialist | 727 Raritan Rd, Suite 101, Clark, NJ 07066-2229 | 2005-08-25 |
| 1851825475 | Samantha Young | Specialist | 156 Broadway, Clark, NJ 07066-1845 | 2017-04-20 |
| 1093862914 | Richard Howard Blum | Specialist | 1457 Raritan Rd, Clark, NJ 07066-1252 | 2007-01-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043817356 | Erica Strubbe-montalvo | Specialist | 135 Larch Ave, Bogota, NJ 07603-1504 | 2020-10-08 |
| 1154937076 | Ines P Serna | Specialist | 7312 Kiesel Pl, North Bergen, NJ 07047-4033 | 2020-09-16 |
| 1568077238 | Michelle Horowitz-firestone | Specialist | 5 Whitman Ter, Long Branch, NJ 07740-9310 | 2020-09-10 |
| 1811509946 | Iris Devaughn | Specialist | 218 High St Apt 6, Burlington City, NJ 08016-4420 | 2020-08-19 |
| 1083223572 | Enlyv Clinics | Specialist | 908 Oak Tree Ave Ste R, South Plainfield, NJ 07080-5135 | 2020-07-30 |
| 1235748971 | North Jersey Sports Medicine & Orthopedic Center, LLC | Specialist | 254b Mountain Ave Ste 201, Hackettstown, NJ 07840-2413 | 2020-07-29 |
| 1255958864 | Tiffany Nicole Pierce | Specialist | 730 Newark Ave Apt 12d, Jersey City, NJ 07306-2816 | 2020-06-30 |
| 1699391557 | Brojan Franchising Inc | Specialist | 76 Highland Trl, Denville, NJ 07834-2033 | 2020-06-17 |
| 1487274288 | Kyle Everage | Specialist | 129 Passaic Ave # 201, Kearny, NJ 07032-1105 | 2020-04-21 |
| 1548880644 | Michal Lasowsky | Specialist | 1 Idaho St, Passaic, NJ 07055-3336 | 2020-04-20 |
| Find all providers with the same taxonomy | ||||
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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.