Provider Demographics
NPI:1417408881
Name:Q SPINE INSTITUTE LLC
Entity Type:Organization
Organization Name:Q SPINE INSTITUTE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:G
Authorized Official - Last Name:QUARTARARO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-674-0336
Mailing Address - Street 1:PO BOX 548
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07653-0548
Mailing Address - Country:US
Mailing Address - Phone:201-674-0336
Mailing Address - Fax:
Practice Address - Street 1:37 W CENTURY RD
Practice Address - Street 2:SUITE 104
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-1466
Practice Address - Country:US
Practice Address - Phone:201-674-0336
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-20
Last Update Date:2016-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07137700207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Single Specialty