Provider Demographics
NPI:1336783471
Name:INTERNATIONAL SPINE & SPORTS INSTITUTE LLC
Entity Type:Organization
Organization Name:INTERNATIONAL SPINE & SPORTS INSTITUTE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:KATZMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-855-2828
Mailing Address - Street 1:1200 ROUTE 22 STE 14
Mailing Address - Street 2:
Mailing Address - City:BRIDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:08807-2943
Mailing Address - Country:US
Mailing Address - Phone:855-586-2615
Mailing Address - Fax:973-564-6092
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:561-855-2828
Practice Address - Fax:561-653-1979
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-01
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Multi-Specialty