Provider Demographics
NPI:1598884009
Name:CHERRY HILL SPINE CENTER, LLC
Entity Type:Organization
Organization Name:CHERRY HILL SPINE CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GREENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:856-489-4480
Mailing Address - Street 1:1878 MARLTON PIKE E
Mailing Address - Street 2:SUITE 2
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-2090
Mailing Address - Country:US
Mailing Address - Phone:856-489-4480
Mailing Address - Fax:856-489-4481
Practice Address - Street 1:1878 MARLTON PIKE E
Practice Address - Street 2:SUITE 2
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-2090
Practice Address - Country:US
Practice Address - Phone:856-489-4480
Practice Address - Fax:856-489-4481
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00610700111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2265999000OtherAMERIHEALTH PLANS
NJ2265999000OtherKEYSTONE PLANS
NJ3344297OtherAETNA HMO AND POS
NJ7064114OtherAETNA PPO
NJ2265999000OtherIBC AND PERSONAL CHOICE
NJ2335635OtherUNITED HEALTH CARE
NJ7064114OtherAETNA PPO
NJU95844Medicare UPIN
NJ2265999000OtherIBC AND PERSONAL CHOICE