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Organization

SEACOAST SPINE & SPORT MEDICAL INSTITUTE

Active
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Organization

SEACOAST SPINE & SPORT MEDICAL INSTITUTE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KHANH NGUYEN MD (PRESIDENT)
(732) 955-0655
Entity
Organization

Contact information

Practice address
40 CORBETT WAY, EATONTOWN, NJ 07724-2263
(732) 955-0655
Mailing address
40 CORBETT WAY, EATONTOWN, NJ 07724-2263
(732) 955-0655

Taxonomy

Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary

Other

Enumeration date
04/02/2021
Last updated
04/02/2021
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