Organization
ULTIMA SPORTS AND SPINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETER BERGER DC (OWNER)
(973) 423-9100
Entity
Organization
Contact information
Practice address
219 LAFAYETTE AVE, HAWTHORNE, NJ 07506-1904
(973) 423-9100
(973) 423-1339
Mailing address
219 LAFAYETTE AVE, HAWTHORNE, NJ 07506-1904
(973) 423-9100
(973) 423-1339
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
—
111NX0800X
Orthopedic Chiropractor
—
—
171100000X
Acupuncturist
—
—
207T00000X
Neurological Surgery Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
—
—
225100000X
Physical Therapist
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
08/14/2020
Last updated
08/24/2020
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