Performance Spine and Sports Medicine East Brunswick

Primary specialty

SpecialistTaxonomy code 174400000X

License

25MA09258600 Issued in NJ

Legal business name

PERFORMANCE SPINE AND SPORTS MEDICINE EAST BRUNSWICK

Practice address

555 State Route 18
East Brunswick, NJ 08816-3713

Phone

(609) 817-0052

NPI assigned

Jul 26, 2016

Organization subpart

No

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

Authorized official

Name

Stacy Salera

Title

Finance Representative

Phone

(609) 817-0052

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1469491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474416000000",
    "number": "1699228650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 STATE ROUTE 18",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088163713",
            "telephone_number": "609-817-0052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 STATE ROUTE 18",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088163713",
            "telephone_number": "609-817-0052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERFORMANCE SPINE AND SPORTS MEDICINE EAST BRUNSWICK",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-26",
        "last_updated": "2016-09-21",
        "status": "A",
        "authorized_official_last_name": "SALERA",
        "authorized_official_first_name": "STACY",
        "authorized_official_title_or_position": "FINANCE REPRESENTATIVE",
        "authorized_official_telephone_number": "609-817-0052"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "NJ",
            "license": "25MA09258600",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "NJ",
            "license": "25MA08922900",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MULTI-SPECIALTY",
            "identifier": "000000",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David Pepose, PA
• Alyssa Perez Falcon
• Ina Patricia Rivera Perez, DPT
• Miriam Perez, LAC
• Performance Spine and Sports Medicine East Brunswick
• Joseph Raymond Perno, MD
• Janice Pesco, LSW
• Jodi Lynn Peska Mosseri, D.O.
• Peter Y Lee, MD, LLC
• Georgina Petropoulos, P.T., D.P.T.

• Specialist in East Brunswick, NJ
• Providers in East Brunswick, NJ by specialty
• Specialist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2016; 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.