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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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