Provider Demographics
NPI:1871844860
Name:SPINE AND HEALTH CENTER OF JERSEY CITY
Entity Type:Organization
Organization Name:SPINE AND HEALTH CENTER OF JERSEY CITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:E
Authorized Official - Last Name:WOHL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:201-984-9055
Mailing Address - Street 1:2520 JOHN F KENNEDY BLVD
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07304-2054
Mailing Address - Country:US
Mailing Address - Phone:201-984-9055
Mailing Address - Fax:201-301-7395
Practice Address - Street 1:574 SUMMIT AVE STE 501
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306
Practice Address - Country:US
Practice Address - Phone:201-761-0001
Practice Address - Fax:201-918-6111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-01
Last Update Date:2018-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC0062450111N00000X
225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty