Organization
EXECUTIVE SPINE SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARL J SPIVAK MD (NEUROSURGEON)
(908) 452-5612
Entity
Organization
Contact information
Practice address
657 WILLOW GROVE ST STE 402, HACKETTSTOWN, NJ 07840
(908) 452-5612
Mailing address
657 WILLOW GROVE ST STE 402, HACKETTSTOWN, NJ 07840-1868
(908) 452-5612
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
003005
NY
Other
Enumeration date
08/28/2016
Last updated
08/28/2016
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