Elite Spine and Sports Care of Fort Lee PC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

ELITE SPINE AND SPORTS CARE OF FORT LEE PC

Practice address

1622 Parker Ave Ste 2B
Fort Lee, NJ 07024-6927

Phone

(201) 592-0800

NPI assigned

Nov 26, 2018

Organization subpart

No

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

Authorized official

Name

Gabriel Hannawi, DCNPI 1013332055

Title

President

Phone

(201) 592-0800

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Practitioners 8

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

• Gabriel Hannawi

  • Chiropractor
  • Totowa, NJ
  • NPI 1013332055
  Medicare reassignment NPD Authorized official
• Jeongmin Hyun, PT, DPT

  • Physical Therapist
  • Fort Lee, NJ
  • NPI 1366252181
  Medicare reassignment Care Compare group NPD
• John Mathai

  • Chiropractor
  • Fort Lee, NJ
  • NPI 1407487051
  Medicare reassignment Care Compare group NPD
• Michael Yarish, DPT

  • Physical Therapist
  • Fort Lee, NJ
  • NPI 1821567553
  Medicare reassignment Care Compare group NPD
• Joseph Michael Cangialosi, OTD, OTR/L

  • Occupational Therapist
  • Totowa, NJ
  • NPI 1861148686
  Medicare reassignment NPD
• Jessica Jozefiak

  • Occupational Therapist
  • Fort Lee, NJ
  • NPI 1346072303
  Medicare reassignment NPD
• Carmen William Guarino, OTR/L

  • Occupational Therapist
  • Wayne, NJ
  • NPI 1467038679
  NPD
• Sean Santagato, DPT

  • Physical Therapist
  • Totowa, NJ
  • NPI 1235406794
  NPD (past)

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

{
    "created_epoch": "1543190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672185600000",
    "number": "1508336298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1622 PARKER AVE STE 2B",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070246927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1622 PARKER AVE STE 2B",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070246927",
            "telephone_number": "201-592-0800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE SPINE AND SPORTS CARE OF FORT LEE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-26",
        "last_updated": "2022-12-28",
        "certification_date": "2022-12-28",
        "status": "A",
        "authorized_official_last_name": "HANNAWI",
        "authorized_official_first_name": "GABRIEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-592-0800",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eastern Diagnostic Services LLC
• Edge Wellness and Physical Therapy, LLC
• Elaine Katz Edlin, RDH
• Ej and JJ Inc (The Medicine Shoppe Pharmacy)
• Elevate PT LLC (Elevate Performance Therapy)
• Amina Elkassir, M.D.
• Elliot L Plotkin DPM (The Foot and Ankle Center of Fort Lee)
• Emka Home Care Services Inc
• Emmanuel Acupuncture
• Endocrinology and Diabetes Associates, LLC

• Physical Therapy Clinic/Center in Fort Lee, NJ
• Providers in Fort Lee, NJ by specialty
• Physical Therapy Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2022; 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.