# SPINE INSTITUTE OF NEW JERSEY LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013465947
- **Authorized official:** DR. DAVID G HARRIS DC (MANAGING ADMINISTRATOR)
- **Authorized official phone:** (973) 925-1881

## Contact information

- **Practice address:** 375 BROADWAY, SUITE 1, PATERSON, NJ 07501-2294
- **Practice address phone:** (973) 925-1881
- **Practice address fax:** (973) 925-1884
- **Mailing address:** 375 BROADWAY, SUITE 1, PATERSON, NJ 07501-2294
- **Mailing address phone:** (973) 925-1881
- **Mailing address fax:** (973) 925-1884

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 38MC00508400 | NJ | Yes |

## Other

- **Enumeration date:** 09/20/2016
- **Last updated:** 09/20/2016