Provider Demographics
NPI:1407650807
Name:FOUNDATION SPINE & ORTHOPAEDICS
Entity type:Organization
Organization Name:FOUNDATION SPINE & ORTHOPAEDICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:D
Authorized Official - Last Name:LONG
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:201-575-2810
Mailing Address - Street 1:1 SEARS DR STE 202
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-3510
Mailing Address - Country:US
Mailing Address - Phone:201-575-2810
Mailing Address - Fax:888-440-7089
Practice Address - Street 1:1 SEARS DR STE 202
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-3510
Practice Address - Country:US
Practice Address - Phone:201-575-2810
Practice Address - Fax:888-440-2810
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-03
Last Update Date:2025-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Single Specialty