Provider Demographics
NPI:1841778040
Name:INTERNATIONAL SPINE INSTITUTE LLC
Entity Type:Organization
Organization Name:INTERNATIONAL SPINE INSTITUTE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:KATZMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:855-586-2615
Mailing Address - Street 1:375 MOUNT PLEASANT AVE STE 205
Mailing Address - Street 2:
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-2751
Mailing Address - Country:US
Mailing Address - Phone:973-376-6595
Mailing Address - Fax:973-741-3900
Practice Address - Street 1:375 MOUNT PLEASANT AVE STE 205
Practice Address - Street 2:
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-2751
Practice Address - Country:US
Practice Address - Phone:855-586-2615
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-31
Last Update Date:2018-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty