Provider Demographics
NPI:1447271689
Name:NEW JERSEY SPINAL MEDICINE AND SURGERY, P.A.
Entity type:Organization
Organization Name:NEW JERSEY SPINAL MEDICINE AND SURGERY, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DUFFEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-251-7725
Mailing Address - Street 1:113 W ESSEX ST STE 201
Mailing Address - Street 2:
Mailing Address - City:MAYWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07607-1023
Mailing Address - Country:US
Mailing Address - Phone:201-251-7725
Mailing Address - Fax:201-251-2599
Practice Address - Street 1:113 W ESSEX ST STE 201
Practice Address - Street 2:
Practice Address - City:MAYWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07607-1023
Practice Address - Country:US
Practice Address - Phone:201-251-7725
Practice Address - Fax:201-251-2599
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ086584Medicare ID - Type Unspecified