Organization
NORTH JERSEY INTERVENTIONAL SPINE CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID M BANDOLA MD (MD)
(862) 248-0668
Entity
Organization
Contact information
Practice address
601 HAMBURG TPKE, SUITE 204, WAYNE, NJ 07470-2048
(862) 248-0668
(862) 248-0669
Mailing address
601 HAMBURG TPKE, SUITE 204, WAYNE, NJ 07470-2048
(862) 248-0668
(862) 248-0669
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
25MA08735700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25MA08735700
MEDICAL LICENSE
NJ
Enumeration date
05/08/2014
Last updated
02/25/2015
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