Provider Demographics
NPI:1629796552
Name:PROMPT MEDICAL SPINE CARE OF NEW JERSEY
Entity Type:Organization
Organization Name:PROMPT MEDICAL SPINE CARE OF NEW JERSEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REVENUE CYCLE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DANESHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CYPRESS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-497-4418
Mailing Address - Street 1:2001 MARCUS AVE STE W170
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11042-2042
Mailing Address - Country:US
Mailing Address - Phone:516-355-0111
Mailing Address - Fax:
Practice Address - Street 1:37 W CENTURY RD STE 104
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-1466
Practice Address - Country:US
Practice Address - Phone:516-355-0111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-17
Last Update Date:2022-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Single Specialty