Provider Demographics
NPI:1235260522
Name:NEW JERSEY SPINE & SPORTS MEDICINE, P.C.
Entity Type:Organization
Organization Name:NEW JERSEY SPINE & SPORTS MEDICINE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:T
Authorized Official - Last Name:FILION
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:201-964-0200
Mailing Address - Street 1:84 ORIENT WAY
Mailing Address - Street 2:
Mailing Address - City:RUTHERFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07070-2052
Mailing Address - Country:US
Mailing Address - Phone:201-964-0200
Mailing Address - Fax:201-964-0220
Practice Address - Street 1:84 ORIENT WAY
Practice Address - Street 2:
Practice Address - City:RUTHERFORD
Practice Address - State:NJ
Practice Address - Zip Code:07070-2052
Practice Address - Country:US
Practice Address - Phone:201-964-0200
Practice Address - Fax:201-964-0220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2008-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB06459100174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ=========OtherMEDICAL OFFICE