Bergen Spine and Sport, LLC

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

Legal business name

BERGEN SPINE AND SPORT, LLC

Practice address

10 Wilsey SQ Ste 132
Ridgewood, NJ 07450-3729

Phone

(201) 389-8987

NPI assigned

Nov 14, 2018

Organization subpart

No

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

Authorized official

Name

Giuseppe Giovatto Jr., DCNPI 1447456629

Title

Owner

Phone

(201) 389-8987

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Giuseppe Giovatto Jr., D.C.

  • Chiropractor
  • Wyckoff, NJ
  • NPI 1447456629

  NJ, Sports Physician

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1542153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1542153600000",
    "number": "1225507643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "522 N MAPLE AVE APT C3",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074501637",
            "telephone_number": "727-599-1695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 WILSEY SQ STE 132",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074503729",
            "telephone_number": "201-389-8987"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "615 Wyckoff Ave Ste 1",
            "address_purpose": "LOCATION",
            "city": "Wyckoff",
            "state": "NJ",
            "postal_code": "074811353",
            "country_code": "US",
            "telephone_number": "201-389-8987",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BERGEN SPINE AND SPORT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-14",
        "last_updated": "2018-11-14",
        "status": "A",
        "authorized_official_last_name": "GIOVATTO",
        "authorized_official_first_name": "GIUSEPPE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "201-389-8987",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Sports Physician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lynn Benson, MSW
• Eric Y. Bentolila, MD
• Bergen Anesthesia Group, P.C.
• Bergen Dermatology Specialists PA
• Bergen Psychiatric Care LLC
• Bergen Valley Acupuncture
• Flora L Bernard, LCSW
• Joshua William Bernheim, M.D.
• Jill Bernice-Woehrle, LPN
• Andrew Bernstein, PT

• All providers in Ridgewood, NJ
• Sports Physician Chiropractor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.