Provider Demographics
NPI:1205619574
Name:NJ SPINE AND BRAIN SURGERY
Entity type:Organization
Organization Name:NJ SPINE AND BRAIN SURGERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RISHI
Authorized Official - Middle Name:N
Authorized Official - Last Name:SHETH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-380-1140
Mailing Address - Street 1:5341 W. ATLANTIC AVE.
Mailing Address - Street 2:STE 302
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-8166
Mailing Address - Country:US
Mailing Address - Phone:561-865-5431
Mailing Address - Fax:
Practice Address - Street 1:401 HAMBURG TURNPIKE
Practice Address - Street 2:STE 204
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-2139
Practice Address - Country:US
Practice Address - Phone:973-380-1140
Practice Address - Fax:866-313-8923
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-18
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty