Organization
PERFORMANCE SPINE AND SPORTS MEDICINE OF BORDENTOWN, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANICE DELELLIS (MANAGER)
(609) 588-8600
Entity
Organization
Contact information
Practice address
9500 K. JOHNSON BLVD, BORDENTOWN, NJ 08505-4400
(609) 588-8600
(609) 588-8602
Mailing address
9500 K. JOHNSON BLVD, BORDENTOWN, NJ 08505-4400
(609) 588-8600
(609) 588-8602
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2081S0010X
PHYSICAL MEDICINE & REHABILITATION/MULT-SPECIALTY GROUP
NJ
Enumeration date
10/16/2013
Last updated
11/07/2013
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