Provider Demographics
NPI:1275086175
Name:SPINE & REHABILITATION CENTER OF SADDLE BROOK
Entity Type:Organization
Organization Name:SPINE & REHABILITATION CENTER OF SADDLE BROOK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:LATZA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:908-764-7704
Mailing Address - Street 1:444 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:SADDLE BROOK
Mailing Address - State:NJ
Mailing Address - Zip Code:07663-5996
Mailing Address - Country:US
Mailing Address - Phone:201-368-0500
Mailing Address - Fax:201-368-0501
Practice Address - Street 1:444 MARKET ST
Practice Address - Street 2:
Practice Address - City:SADDLE BROOK
Practice Address - State:NJ
Practice Address - Zip Code:07663-5996
Practice Address - Country:US
Practice Address - Phone:201-368-0500
Practice Address - Fax:201-368-0501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-27
Last Update Date:2016-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty