Innovative Spine Care, LLC
Physical Medicine & Rehabilitation, Pain Medicine in Paramus, New Jersey
1952425621- Practice location
- 18 W Ridgewood Ave Fl 2, Paramus, NJ 07652-2333
- Phone
- 201-444-0020
- Fax
- 201-444-0026
- Last updated
- April 12, 2023
Innovative Spine Care, LLC is a healthcare organization based in Paramus, NJ. Innovative Spine Care, LLC practices in Paramus, NJ. The NPI Number for Innovative Spine Care, LLC is 1952425621 and holds a License No. 25MA07099100 (NJ). The current practice location address for Innovative Spine Care, LLC is 18 W Ridgewood Ave Fl 2, Paramus, NJ 07652-2333 and can be reached out via phone at 201-444-0020 and via fax at 201-444-0026.
Provider Profile Details
- NPI Number
- 1952425621
- Provider Name
- Innovative Spine Care, LLC
- Provider Entity Type
- Organization
- Address
- 18 W Ridgewood Ave Fl 2, Paramus, NJ 07652-2333
- Phone Number
- 201-444-0020
- Fax Number
- 201-444-0026
- Primary Taxonomy
- Physical Medicine & Rehabilitation, Pain Medicine · 2081P2900X
- Organization Subpart
- No
- Authorized Official
- Dr. Tatiana Sharahy, MD · Owner · 201-444-0020
- Other Names
- Pure Anti Aging Medical Center (Doing Business As)
- Provider Enumeration Date
- March 19, 2007
- Last Update Date
- April 12, 2023
- Certification Date
- April 12, 2023
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 18 W Ridgewood Ave Fl 2
Paramus, NJ 07652-2333 - City
- Paramus
- State
- New Jersey
- Zip
- 07652-2333
- Phone Number
- 201-444-0020
- Fax Number
- 201-444-0026
Provider Business Mailing Address Details
- Address
- 1144 E Ridgewood Ave
Ridgewood, NJ 07450-3915 - City
- Ridgewood
- State
- NJ
- Zip
- 07450-3915
- Phone Number
- 201-444-0020
- Fax Number
- 201-444-0026
License Information
- License Number (1)
- 25MA07099100
- License State (1)
- NJ
- Taxonomy (1)
- Chiropractor, Rehabilitation · 111NR0400X
- License Number (2)
- 25MA07099100
- License State (2)
- NJ
- Taxonomy (2)
- Internal Medicine · 207R00000X
- License Number (3)
- 25MA07099100
- License State (3)
- NJ
- Taxonomy (3)
- Physical Medicine & Rehabilitation, Pain Medicine · 2081P2900X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Innovative Spine Care, LLC?
The NPI number of Innovative Spine Care, LLC is 1952425621. It was assigned on March 19, 2007 and is currently active in the NPPES registry.
What is the specialty of Innovative Spine Care, LLC?
Innovative Spine Care, LLC is registered under the primary taxonomy Physical Medicine & Rehabilitation, Pain Medicine (code 2081P2900X), licensed in NJ under license number 25MA07099100.
Where does Innovative Spine Care, LLC practice?
The practice location is 18 W Ridgewood Ave Fl 2, Paramus, NJ 07652-2333. The office can be reached at 201-444-0020 (phone) or 201-444-0026 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1952425621 directly on the NPPES registry website.