Advanced Spine Care Physical Therapy

Primary specialty

SpecialistTaxonomy code 174400000X

License

QA001535 Issued in NJ

Legal business name

ADVANCED SPINE CARE PHYSICAL THERAPY

Practice address

700 Rahway Ave
1St Floor
Union, NJ 07083-6634

Phone

(732) 688-1991

NPI assigned

May 26, 2011

Last updated

May 26, 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

Carol A. Mendillo

Title

Office Manager

Phone

(732) 741-5085

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1306368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306368000000",
    "number": "1376836148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 RAHWAY AVE",
            "address_2": "1ST FLOOR",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070836634",
            "telephone_number": "908-688-1991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 RAHWAY AVE",
            "address_2": "1ST FLOOR",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070836634",
            "telephone_number": "732-688-1991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED SPINE CARE PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-26",
        "last_updated": "2011-05-26",
        "status": "A",
        "authorized_official_last_name": "MENDILLO",
        "authorized_official_first_name": "CAROL",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "732-741-5085"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NJ",
            "license": "QA001535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Union, NJ
• Providers in Union, NJ by specialty
• Specialist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 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.