Organization
NJ VEIN SPECIALISTS
Active
Parent organization
PROGRESSIVE SPINE & ORTHOPAEDICS, LLC
Other names
NJ VEIN SPECIALISTS
Organization subpart
Yes
Provider details
NPI number
Legal business name
PROGRESSIVE SPINE & ORTHOPAEDICS, LLC
Authorized official
MS. JENNIFER JENNACO (ADMINISTRATOR)
(201) 371-3932
Entity
Organization
Contact information
Practice address
208 HARRISTOWN RD # LEVEL1, GLEN ROCK, NJ 07452-3308
(201) 371-3932
(201) 514-1434
Mailing address
PO BOX 500, MARLBORO, NJ 07746-0500
(201) 371-3932
(201) 514-1434
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
208600000X
Surgery Physician
—
—
2086S0129X
Vascular Surgery Physician
Primary
—
—
Other
Enumeration date
11/04/2022
Last updated
11/04/2022
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