Atlantic Spine Center

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

License

25MA07186700 Issued in NJ

Legal business name

ATLANTIC SPINE CENTER

Practice address

475 Prospect Ave
Suite 110
West Orange, NJ 07052-4197

Phone

(973) 419-0200

Fax

(973) 419-0223

NPI assigned

Jul 17, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Kaixuan Liu, M.D. PHD

Title

President

Phone

(973) 419-0200

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445385600000",
    "number": "1730106436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 PROSPECT AVE",
            "address_2": "SUITE 110",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070524197",
            "telephone_number": "973-419-0200",
            "fax_number": "972-341-9022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 PROSPECT AVE",
            "address_2": "SUITE 110",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070524197",
            "telephone_number": "973-419-0200",
            "fax_number": "973-419-0223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTIC SPINE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-17",
        "last_updated": "2015-10-21",
        "status": "A",
        "authorized_official_last_name": "LIU",
        "authorized_official_first_name": "KAIXUAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "973-419-0200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D. PHD"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NJ",
            "license": "25MA07186700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Interventional Pain Medicine Physician in West Orange, NJ
• Providers in West Orange, NJ by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2015; 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.