Provider Demographics
NPI:1598012486
Name:NJ COMMUNITY SPINE AND PAIN LLC
Entity Type:Organization
Organization Name:NJ COMMUNITY SPINE AND PAIN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:
Authorized Official - Last Name:GIARDINA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:732-503-4079
Mailing Address - Street 1:864 ROUTE 37 W
Mailing Address - Street 2:SUITE 1
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-5033
Mailing Address - Country:US
Mailing Address - Phone:732-503-4079
Mailing Address - Fax:732-503-4127
Practice Address - Street 1:864 ROUTE 37 W
Practice Address - Street 2:SUITE 1
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-5033
Practice Address - Country:US
Practice Address - Phone:732-503-4079
Practice Address - Fax:732-503-4127
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-09
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty