Provider Demographics
NPI:1710103288
Name:IGEA BRAIN & SPINE,PA
Entity Type:Organization
Organization Name:IGEA BRAIN & SPINE,PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:FINEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:BS, CMM
Authorized Official - Phone:908-688-8800
Mailing Address - Street 1:1057 COMMERCE AVENUE
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-5025
Mailing Address - Country:US
Mailing Address - Phone:908-688-8800
Mailing Address - Fax:908-688-2377
Practice Address - Street 1:1057 COMMERCE AVENUE
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-5025
Practice Address - Country:US
Practice Address - Phone:908-688-8800
Practice Address - Fax:908-688-2377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2014-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA34235207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJDA9388OtherRR MEDICARE
NJDA9388OtherRR MEDICARE