# BERGENLINE SPINE AND HEALTHCARE CENTER PC

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

## Provider details

- **NPI number:** 1699048322
- **Authorized official:** PETER WOHL D.C. (MANAGER)
- **Authorized official phone:** (201) 758-0099

## Contact information

- **Practice address:** 6000 KENNEDY BLVD W, WEST NEW YORK, NJ 07093-1414
- **Practice address phone:** (201) 758-0099
- **Practice address fax:** (201) 758-2992
- **Mailing address:** PO BOX 5262, WEST NEW YORK, NJ 07093-9262
- **Mailing address phone:** (201) 758-0099
- **Mailing address fax:** (201) 758-2992

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | — | NULL | — |
| 111N00000X | Chiropractor | — | — | — |
| 171100000X | Acupuncturist | 25MZ00059400 | NJ | — |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | NULL | — |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | — |
| 207X00000X | Orthopaedic Surgery Physician | — | — | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | — |
| 208VP0014X | Interventional Pain Medicine Physician | — | NULL | — |
| 208VP0014X | Interventional Pain Medicine Physician | — | — | — |
| 225100000X | Physical Therapist | 40QA00729000 | NJ | — |

## Other

- **Enumeration date:** 02/10/2012
- **Last updated:** 05/24/2013