# PREMIER SPINE AND SPORTS MEDICINE, P.C.

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

## Provider details

- **NPI number:** 1811236672
- **Authorized official:** DR. RUBY E KIM M.D. (PHYSICIAN)
- **Authorized official phone:** (201) 242-1600

## Contact information

- **Practice address:** 1555 CENTER AVE, FORT LEE, NJ 07024-4612
- **Practice address phone:** (201) 242-1600
- **Mailing address:** 1555 CENTER AVE, 2ND FLOOR, FORT LEE, NJ 07024-4612

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | 25MA08795900 | NJ | Yes |

## Other

- **Enumeration date:** 02/13/2013
- **Last updated:** 09/27/2013