Organization
NEW JERSEY SPINE & SPORT REHABILITATION MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SIREEN M GOPAL MD (MD)
(718) 794-0600
Entity
Organization
Contact information
Practice address
129 NEWARK AVE, JERSEY CITY, NJ 07302-2811
(718) 794-0600
Mailing address
2008 EASTCHESTER RD STE A, BRONX, NY 10461-2252
(718) 794-0600
(718) 794-9899
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
25MA09845900
NJ
Other
Enumeration date
07/25/2017
Last updated
07/25/2017
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