# PALISADES REHAB AND SPINAL CARE GROUP,

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

## Provider details

- **NPI number:** 1346472321
- **Authorized official:** MR. GEORGE JOHN BUSSANICH (OWNER)
- **Authorized official phone:** (201) 840-5888

## Contact information

- **Practice address:** 596 ANDERSON AVE, SUITE 108, CLIFFSIDE PARK, NJ 07010-1831
- **Practice address phone:** (201) 840-5888
- **Mailing address:** 596 ANDERSON AVE, SUITE 108, CLIFFSIDE PARK, NJ 07010-1831
- **Mailing address phone:** (201) 840-5888

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | 38MC00626600 | NJ | — |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | 25MA06277300 | NJ | — |
| 207R00000X | Internal Medicine Physician | 25MA04969400 | NJ | — |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | 25MA07789800 | NJ | Yes |
| 208VP0014X | Interventional Pain Medicine Physician | 25MB08234500 | NJ | — |

## Other

- **Enumeration date:** 08/10/2009
- **Last updated:** 10/07/2011