Provider Demographics
NPI:1750977054
Name:SPINE AND BRAIN MONITORING LLC
Entity type:Organization
Organization Name:SPINE AND BRAIN MONITORING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:GIUNTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-855-7570
Mailing Address - Street 1:14 OLD BRIDGE TPKE
Mailing Address - Street 2:
Mailing Address - City:SOUTH RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08882-2496
Mailing Address - Country:US
Mailing Address - Phone:973-855-7570
Mailing Address - Fax:
Practice Address - Street 1:14 OLD BRIDGE TPKE
Practice Address - Street 2:
Practice Address - City:SOUTH RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08882-2496
Practice Address - Country:US
Practice Address - Phone:973-855-7570
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-21
Last Update Date:2020-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204R00000XAllopathic & Osteopathic PhysiciansElectrodiagnostic MedicineGroup - Single Specialty