Provider Demographics
NPI:1437512514
Name:NEW CENTURY SPINE AND OUTPATIENT SURGICAL INSTITUTE, LLC
Entity Type:Organization
Organization Name:NEW CENTURY SPINE AND OUTPATIENT SURGICAL INSTITUTE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:P
Authorized Official - Last Name:RAGUKONIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-986-1003
Mailing Address - Street 1:37 W CENTURY RD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-1466
Mailing Address - Country:US
Mailing Address - Phone:201-986-1003
Mailing Address - Fax:201-986-1680
Practice Address - Street 1:37 W CENTURY RD
Practice Address - Street 2:SUITE 106
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-1466
Practice Address - Country:US
Practice Address - Phone:201-986-1003
Practice Address - Fax:201-986-1680
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-05
Last Update Date:2016-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical