Provider Demographics
NPI:1437737442
Name:CENTER FOR SPINE SURGERY LLC
Entity Type:Organization
Organization Name:CENTER FOR SPINE SURGERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT-BOARD OF MANAGERS
Authorized Official - Prefix:DR
Authorized Official - First Name:PAWAN
Authorized Official - Middle Name:
Authorized Official - Last Name:RASTOGI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:302-463-5499
Mailing Address - Street 1:1219 JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19801-1033
Mailing Address - Country:US
Mailing Address - Phone:302-984-7178
Mailing Address - Fax:302-777-3444
Practice Address - Street 1:1219 JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19801-1033
Practice Address - Country:US
Practice Address - Phone:302-984-7178
Practice Address - Fax:302-777-3444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-31
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical