Performance Spine and Sports Medicine of Bordentown, LLC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

PERFORMANCE SPINE AND SPORTS MEDICINE OF BORDENTOWN, LLC

Practice address

9500 K. Johnson Blvd
Bordentown, NJ 08505-4400

Phone

(609) 588-8600

Fax

(609) 588-8602

NPI assigned

Oct 16, 2013

Organization subpart

No

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

Authorized official

Name

Janice Delellis

Title

Manager

Phone

(609) 588-8600

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1381881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383782400000",
    "number": "1437587193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9500 K. JOHNSON BLVD",
            "city": "BORDENTOWN",
            "state": "NJ",
            "postal_code": "085054400",
            "telephone_number": "609-588-8600",
            "fax_number": "609-588-8602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 K. JOHNSON BLVD",
            "city": "BORDENTOWN",
            "state": "NJ",
            "postal_code": "085054400",
            "telephone_number": "609-588-8600",
            "fax_number": "609-588-8602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERFORMANCE SPINE AND SPORTS MEDICINE OF BORDENTOWN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-16",
        "last_updated": "2013-11-07",
        "status": "A",
        "authorized_official_last_name": "DELELLIS",
        "authorized_official_first_name": "JANICE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "609-588-8600"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL MEDICINE & REHABILITATION/MULT-SPECIALTY GROUP",
            "identifier": "2081S0010X",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Zarina Paz
• Pelvicfit LLC
• Sanziana Penafiel Ruiz Badulescu
• Pennreach
• Performance Spine and Sports Medicine of Bordentown, LLC
• Katherine Anne Petty, PT, DPT
• Paul John Pigoncelli, MA. LPC.
• Veronica Furigay Pomasin, APN
• Jordyn Pontoriero, APN, FNP-C
• Melanie Ann Powell, DO

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2013; 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.