Provider Demographics
NPI:1952611410
Name:FAIR LAWN SPINE & INJURY CENTER, LLC
Entity Type:Organization
Organization Name:FAIR LAWN SPINE & INJURY CENTER, LLC
Other - Org Name:TAFFURI INTEGRATED WELLNESS CENTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:M
Authorized Official - Last Name:TAFFURI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:201-773-0909
Mailing Address - Street 1:23-00 ROUTE 208 SOUTH
Mailing Address - Street 2:SUITE 2-6
Mailing Address - City:FAIR LAWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07410-1559
Mailing Address - Country:US
Mailing Address - Phone:201-773-0909
Mailing Address - Fax:201-625-6505
Practice Address - Street 1:23-00 ROUTE 208 SOUTH
Practice Address - Street 2:SUITE 2-6
Practice Address - City:FAIR LAWN
Practice Address - State:NJ
Practice Address - Zip Code:07410-1559
Practice Address - Country:US
Practice Address - Phone:201-773-0909
Practice Address - Fax:201-625-6505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-18
Last Update Date:2014-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00679600111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty