Provider Demographics
NPI:1598138794
Name:TOTAL SPINE AND ORTHO ASSOCIATES, LLC
Entity Type:Organization
Organization Name:TOTAL SPINE AND ORTHO ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILSON
Authorized Official - Middle Name:
Authorized Official - Last Name:NUESA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-955-2284
Mailing Address - Street 1:6 DANSFIELD CT
Mailing Address - Street 2:
Mailing Address - City:UPPER SADDLE RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07458-1777
Mailing Address - Country:US
Mailing Address - Phone:201-955-2284
Mailing Address - Fax:201-955-2267
Practice Address - Street 1:6 DANSFIELD CT
Practice Address - Street 2:
Practice Address - City:UPPER SADDLE RIVER
Practice Address - State:NJ
Practice Address - Zip Code:07458-1777
Practice Address - Country:US
Practice Address - Phone:201-955-2284
Practice Address - Fax:201-955-2267
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-10
Last Update Date:2015-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty