Provider Demographics
NPI:1366182313
Name:PREMIER SPINE & REHABILITATION LLC
Entity type:Organization
Organization Name:PREMIER SPINE & REHABILITATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLER
Authorized Official - Prefix:
Authorized Official - First Name:MILAGROS
Authorized Official - Middle Name:
Authorized Official - Last Name:FIGUEREDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-857-2653
Mailing Address - Street 1:444 MARKET ST STE 5
Mailing Address - Street 2:
Mailing Address - City:SADDLE BROOK
Mailing Address - State:NJ
Mailing Address - Zip Code:07663-5996
Mailing Address - Country:US
Mailing Address - Phone:201-880-1400
Mailing Address - Fax:866-420-3319
Practice Address - Street 1:444 MARKET ST STE 5
Practice Address - Street 2:
Practice Address - City:SADDLE BROOK
Practice Address - State:NJ
Practice Address - Zip Code:07663-5996
Practice Address - Country:US
Practice Address - Phone:201-880-1400
Practice Address - Fax:866-420-3319
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-29
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty