Provider Demographics
NPI:1285378885
Name:RADCLIFF SPINE
Entity type:Organization
Organization Name:RADCLIFF SPINE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KRISTEN
Authorized Official - Middle Name:E
Authorized Official - Last Name:RADCLIFF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-800-3472
Mailing Address - Street 1:415 NEW RD STE 3
Mailing Address - Street 2:
Mailing Address - City:SOMERS POINT
Mailing Address - State:NJ
Mailing Address - Zip Code:08244-2106
Mailing Address - Country:US
Mailing Address - Phone:609-800-3472
Mailing Address - Fax:609-800-3472
Practice Address - Street 1:415 NEW RD STE 3
Practice Address - Street 2:
Practice Address - City:SOMERS POINT
Practice Address - State:NJ
Practice Address - Zip Code:08244-2106
Practice Address - Country:US
Practice Address - Phone:609-800-3472
Practice Address - Fax:609-800-3472
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-21
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Single Specialty