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Contact Information

BERGEN SPINE & REHABILITATION, LLC
136 N WASHINGTON AVENUE
103
BERGENFIELD, NJ07621
 Phone: 201-387-2800
 Fax: 201-387-2248
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Occupational Health

111NX0100X 35 Chiropractic
 

Physical Therapist

225100000X 65 Physical Therapist in Private Practice
Indicates primary specialty

NPI Profile & details for BERGEN SPINE & REHABILITATION, LLC

NPI # 1992804868
LBN Legal business name BERGEN SPINE & REHABILITATION, LLC
Authorized official WAYNE POLLER - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 09/21/2006
Last updated 02/04/2009 - About 17 years ago
Identifiers
NJ License # MC02082
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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