Organization
MODERN SPINE INSTITUTE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GRIGORY GOLDBERG MD (SOLE MBR)
(732) 804-1091
Entity
Organization
Contact information
Practice address
1135 CLIFTON AVE STE 208, CLIFTON, NJ 07013-3643
(862) 336-9696
(862) 336-9697
Mailing address
1135 CLIFTON AVE STE 208, CLIFTON, NJ 07013-3643
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
—
—
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
—
—
Other
Enumeration date
04/03/2024
Last updated
04/03/2024
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