Provider Demographics
NPI:1821981879
Name:SPINE AND JOINT CARE OF NJ LLC
Entity type:Organization
Organization Name:SPINE AND JOINT CARE OF NJ LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ILANA
Authorized Official - Middle Name:
Authorized Official - Last Name:ETELZON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-644-2481
Mailing Address - Street 1:3 SOMERSET LN # 500
Mailing Address - Street 2:
Mailing Address - City:EDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:07020-2419
Mailing Address - Country:US
Mailing Address - Phone:908-906-7813
Mailing Address - Fax:908-906-7813
Practice Address - Street 1:1111 PAULISON AVE
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07011-3600
Practice Address - Country:US
Practice Address - Phone:908-906-7813
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-29
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Single Specialty
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty