Provider Demographics
NPI:1184948846
Name:ELMWOOD PARK SPINE CARE
Entity type:Organization
Organization Name:ELMWOOD PARK SPINE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ARVINDER
Authorized Official - Middle Name:SINGH
Authorized Official - Last Name:DHILLON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:781-710-3843
Mailing Address - Street 1:62 WOODWARD LN
Mailing Address - Street 2:
Mailing Address - City:BASKING RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07920-2723
Mailing Address - Country:US
Mailing Address - Phone:781-710-3843
Mailing Address - Fax:908-647-3293
Practice Address - Street 1:554 BOULEVARD
Practice Address - Street 2:
Practice Address - City:ELMWOOD PARK
Practice Address - State:NJ
Practice Address - Zip Code:07407-2031
Practice Address - Country:US
Practice Address - Phone:201-797-4500
Practice Address - Fax:201-797-8005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-23
Last Update Date:2010-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA084044002081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Multi-Specialty