Organization
BERGEN SPINE ASSOCIATES PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROMAN KOSIBOROD D.O. (OWNER/PRESIDENT)
(201) 982-4706
Entity
Organization
Contact information
Practice address
55 MEADOWLANDS PKWY, SECAUCUS, NJ 07094-2977
(201) 982-4706
Mailing address
55 MEADOWLANDS PKWY, SECAUCUS, NJ 07094-2977
(201) 982-4706
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
25 MB07566200
NJ
Other
Enumeration date
04/14/2014
Last updated
04/14/2014
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