Provider Demographics
NPI:1215183157
Name:SPINALAID HEALTHCARE
Entity Type:Organization
Organization Name:SPINALAID HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDIACL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:VILLANI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:973-648-0084
Mailing Address - Street 1:9-25 ALLING STREET
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07102
Mailing Address - Country:US
Mailing Address - Phone:973-648-0084
Mailing Address - Fax:
Practice Address - Street 1:9-25 ALLING STREET
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07102
Practice Address - Country:US
Practice Address - Phone:973-648-0084
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-12
Last Update Date:2008-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00530000111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty