Organization
ORTHOPAEDICS SPINE AND SPORTS MEDICINE LLC
Active
Other names
Total Orthopedics and Sports Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE TASSO (CREDENTIALING MANAGER)
(516) 795-3033
Entity
Organization
Contact information
Practice address
16 E 29TH ST FL 2, BAYONNE, NJ 07002-4603
(201) 971-7070
(201) 339-2109
Mailing address
12 UNQUA RD, MASSAPEQUA, NY 11758-6727
(516) 795-3033
(516) 654-9358
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
—
—
Other
Enumeration date
11/16/2022
Last updated
11/16/2022
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