Provider Demographics
NPI:1437216330
Name:ROSELAND SPINAL REHABILITATION CENTER PC
Entity Type:Organization
Organization Name:ROSELAND SPINAL REHABILITATION CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:A
Authorized Official - Last Name:CAPRIGLIONE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:973-228-1488
Mailing Address - Street 1:204 EAGLE ROCK AVENUE
Mailing Address - Street 2:
Mailing Address - City:ROSELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:07068
Mailing Address - Country:US
Mailing Address - Phone:973-228-1488
Mailing Address - Fax:973-228-4988
Practice Address - Street 1:204 EAGLE ROCK AVENUE
Practice Address - Street 2:
Practice Address - City:ROSELAND
Practice Address - State:NJ
Practice Address - Zip Code:07068
Practice Address - Country:US
Practice Address - Phone:973-228-1488
Practice Address - Fax:973-228-4988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ081881Medicare ID - Type Unspecified