Provider Demographics
NPI:1760976120
Name:AIM HEALTH THE SPINE AND REGENERATIVE MEDICINE INSTITUTE OF NY & NJ
Entity Type:Organization
Organization Name:AIM HEALTH THE SPINE AND REGENERATIVE MEDICINE INSTITUTE OF NY & NJ
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:PERNA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:201-681-2544
Mailing Address - Street 1:65 E NORTHFIELD RD
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-4231
Mailing Address - Country:US
Mailing Address - Phone:201-681-2544
Mailing Address - Fax:
Practice Address - Street 1:65 E NORTHFIELD RD
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-4231
Practice Address - Country:US
Practice Address - Phone:201-681-2544
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-19
Last Update Date:2018-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA101863002081S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports MedicineGroup - Single Specialty