Provider Demographics
NPI:1063537470
Name:NEW JERSEY BRAIN & SPINE PC
Entity type:Organization
Organization Name:NEW JERSEY BRAIN & SPINE PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:VIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:TZIAGAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-342-2550
Mailing Address - Street 1:650 FROM RD STE 220
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-3551
Mailing Address - Country:US
Mailing Address - Phone:201-342-2550
Mailing Address - Fax:201-342-7171
Practice Address - Street 1:650 FROM RD STE 220
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-3551
Practice Address - Country:US
Practice Address - Phone:201-342-2550
Practice Address - Fax:201-342-7171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Multi-Specialty
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Multi-Specialty
No2084P0005XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurodevelopmental DisabilitiesGroup - Multi-Specialty
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1063537470OtherNPI
NJ6146010001Medicare NSC
NJ024869Medicare PIN