Palisades Rehab and Spinal Care Group,

Primary specialty

Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X

License

25MA07789800 Issued in NJ

Legal business name

PALISADES REHAB AND SPINAL CARE GROUP,

Practice address

596 Anderson Ave
Suite 108
Cliffside Park, NJ 07010-1831

Phone

(201) 840-5888

NPI assigned

Aug 10, 2009

Last updated

Oct 7, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. George John Bussanich

Title

Owner

Phone

(201) 840-5888

Specialties & licenses 5

Addresses

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

{
    "created_epoch": "1249862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317945600000",
    "number": "1346472321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "596 ANDERSON AVE",
            "address_2": "SUITE 108",
            "city": "CLIFFSIDE PARK",
            "state": "NJ",
            "postal_code": "070101831",
            "telephone_number": "201-840-5888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "596 ANDERSON AVE",
            "address_2": "SUITE 108",
            "city": "CLIFFSIDE PARK",
            "state": "NJ",
            "postal_code": "070101831",
            "telephone_number": "201-840-5888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALISADES REHAB AND SPINAL CARE GROUP,",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-10",
        "last_updated": "2011-10-07",
        "status": "A",
        "authorized_official_last_name": "BUSSANICH",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "201-840-5888",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00626600",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NJ",
            "license": "25MA06277300",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA04969400",
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "NJ",
            "license": "25MA07789800",
            "primary": true
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NJ",
            "license": "25MB08234500",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yassam Tiffany Osbourne, REGISTERED NURSE
• OT Steps LLC
• Maria Isabel Pachon Romero, MD
• Anagha A Padmawar, D.D.S
• Palisades Rehab and Physical Therapy Center, LLC
• Palisades Urgent Care, LLC
• Jalpa Patel, DPT
• Upasna Patel, P.T
• Carmen Frida Pena Pujals, DDS
• Felix Eduardo Perez, P.T.

• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Cliffside Park, NJ
• Providers in Cliffside Park, NJ by specialty
• Pain Medicine (Physical Medicine & Rehabilitation) Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2011; 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.