Provider Demographics
NPI:1619581105
Name:JERSEY SHORE SPINE CENTER
Entity Type:Organization
Organization Name:JERSEY SHORE SPINE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAMMITO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:732-908-6226
Mailing Address - Street 1:442 LACEY RD STE 7
Mailing Address - Street 2:
Mailing Address - City:FORKED RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08731-2436
Mailing Address - Country:US
Mailing Address - Phone:609-693-2020
Mailing Address - Fax:609-488-4141
Practice Address - Street 1:442 LACEY RD STE 7
Practice Address - Street 2:
Practice Address - City:FORKED RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08731-2436
Practice Address - Country:US
Practice Address - Phone:609-693-2020
Practice Address - Fax:609-488-4141
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-02
Last Update Date:2020-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081N0008XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationNeuromuscular MedicineGroup - Single Specialty