Old Bridge Spine & Wellness Center,PA

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

OLD BRIDGE SPINE & WELLNESS CENTER,PA

Practice address

210 Mounts Corner Dr
Freehold, NJ 07728-2547

Phone

(732) 414-2700

NPI assigned

Apr 12, 2019

Organization subpart

Yes

Parent organization

OLD BRIDGE SPINE AND WELLNESS PAAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Yamilia C Nelson

Title

Billing Coordinator

Phone

(732) 320-6285

Specialties & licenses 1

Addresses

Part of

Old Bridge Spine Wellness Centerpa

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1555027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1555027200000",
    "number": "1104389485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "144 ROUTE 34",
            "city": "MATAWAN",
            "state": "NJ",
            "postal_code": "077472132",
            "telephone_number": "732-320-6285",
            "fax_number": "732-374-9864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 MOUNTS CORNER DR",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077282547",
            "telephone_number": "732-414-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLD BRIDGE SPINE & WELLNESS CENTER,PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OLD BRIDGE SPINE AND WELLNESS PA",
        "enumeration_date": "2019-04-12",
        "last_updated": "2019-04-12",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "YAMILIA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "BILLING COORDINATOR",
        "authorized_official_telephone_number": "732-320-6285",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Freehold, NJ
• Providers in Freehold, NJ by specialty
• Durable Medical Equipment & Medical Supplies in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.