Provider Demographics
NPI:1023224029
Name:UNIVERSITY SPINE CENTER, P.C.
Entity Type:Organization
Organization Name:UNIVERSITY SPINE CENTER, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ARASH
Authorized Official - Middle Name:
Authorized Official - Last Name:EMAMI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-686-0700
Mailing Address - Street 1:504 VALLEY RD
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-3534
Mailing Address - Country:US
Mailing Address - Phone:973-686-0700
Mailing Address - Fax:973-686-0701
Practice Address - Street 1:504 VALLEY RD
Practice Address - Street 2:2ND FLOOR
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-3534
Practice Address - Country:US
Practice Address - Phone:973-686-0700
Practice Address - Fax:973-686-0701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2008-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ71196174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ128016Medicare PIN