Organization
SPINE CARE AND REHABILITATION, INC.
Active
Organization
SPINE CARE AND REHABILITATION, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH J KOPACZ MD (VICE PRESIDENT)
(973) 226-2725
Entity
Organization
Contact information
Practice address
200 SO. ORANGE AVE, SUITE 180 ANNEX, LIVINGSTON, NJ 07039
(973) 226-2725
(973) 226-3270
Mailing address
200 SO. ORANGE AVE, SUITE 180 ANNEX, LIVINGSTON, NJ 07039
(973) 226-2725
(973) 226-3270
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
115006600
US DEPT OF LABOR
—
01
—
CL40186
OXFORD
—
Enumeration date
09/21/2006
Last updated
04/08/2016
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