# INSTITUTE FOR SPINE & SCOLIOSIS PA

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

## Provider details

- **NPI number:** 1487729687
- **Authorized official:** DR. MARK DARRYL ANTONACCI SPINE SURGEON MD (DIRECTOR)
- **Authorized official phone:** (609) 912-1500

## Contact information

- **Practice address:** 3100 PRINCETON PIKE, BLDG 1, LAWRENCEVILLE, NJ 08648
- **Practice address phone:** (609) 912-1500
- **Practice address fax:** (609) 912-1600
- **Mailing address:** 3100 PRINCETON PIKE, BLDG 1, LAWRENCEVILLE, NJ 08648
- **Mailing address phone:** (609) 912-1500
- **Mailing address fax:** (609) 912-1600

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | 213845-1 | NY | — |
| 207X00000X | Orthopaedic Surgery Physician | 25MA06999100 | NJ | Yes |
| 207X00000X | Orthopaedic Surgery Physician | MD068759L | PA | — |

## Other

- **Enumeration date:** 11/22/2006
- **Last updated:** 01/05/2011