# NJ VEIN SPECIALISTS

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PROGRESSIVE SPINE & ORTHOPAEDICS, LLC
- **Other names:** NJ VEIN SPECIALISTS
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1437866878
- **Legal business name:** PROGRESSIVE SPINE & ORTHOPAEDICS, LLC
- **Authorized official:** MS. JENNIFER JENNACO (ADMINISTRATOR)
- **Authorized official phone:** (201) 371-3932

## Contact information

- **Practice address:** 208 HARRISTOWN RD \# LEVEL1, GLEN ROCK, NJ 07452-3308
- **Practice address phone:** (201) 371-3932
- **Practice address fax:** (201) 514-1434
- **Mailing address:** PO BOX 500, MARLBORO, NJ 07746-0500
- **Mailing address phone:** (201) 371-3932
- **Mailing address fax:** (201) 514-1434

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 174400000X | Specialist | — | NULL | — |
| 174400000X | Specialist | — | — | — |
| 208600000X | Surgery Physician | — | NULL | — |
| 208600000X | Surgery Physician | — | — | — |
| 2086S0129X | Vascular Surgery Physician | — | NULL | Yes |
| 2086S0129X | Vascular Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/04/2022
- **Last updated:** 11/04/2022