Bergen Spine & Rehabilitation, LLC

Primary specialty

Occupational Health ChiropractorTaxonomy code 111NX0100X

License

MC02082 Issued in NJ

Legal business name

BERGEN SPINE & REHABILITATION, LLC

Practice address

136 N Washington Avenue
103
Bergenfield, NJ 07621

Phone

(201) 387-2800

Fax

(201) 387-2248

NPI assigned

Sep 21, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Wayne M Poller, DCNPI 1083699292

Title

Owner

Phone

(201) 387-2800

Specialties & licenses 2

Addresses

Other names 1

• Poller Chiropractic Center Former legal business name

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 6

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

• Wayne M Poller, DC

  • Chiropractor
  • Bergenfield, NJ
  • NPI 1083699292

  NJ

  Medicare reassignment Care Compare group NPD Authorized official
• Rose Ann Yu Tamayo, PT

  • Physical Therapist
  • New York, NY
  • NPI 1124349519

  NJ, Physical Therapist

  Medicare reassignment Care Compare group NPD
• Joan D. Timbang, PT

  • Physical Therapist
  • Englewood, NJ
  • NPI 1972688802

  NJ, Physical Therapist

  Medicare reassignment NPD
• Eduardo B Deang, PT

  • Physical Therapist
  • Bergenfield, NJ
  • NPI 1033250303
  NPD (past)
• Gloria Dones

  • Physical Therapist
  • Bergenfield, NJ
  • NPI 1689083263
  NPD (past)
• Rhonnie Cayaban Lugue, PT

  • Physical Therapist
  • Union, NJ
  • NPI 1760408496
  NPD (past)

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233705600000",
    "number": "1992804868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 N WASHINGTON AVENUE",
            "address_2": "103",
            "city": "BERGENFIELD",
            "state": "NJ",
            "postal_code": "07621",
            "telephone_number": "201-387-2800",
            "fax_number": "201-387-2248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 N WASHINGTON AVENUE",
            "address_2": "103",
            "city": "BERGENFIELD",
            "state": "NJ",
            "postal_code": "07621",
            "telephone_number": "201-387-2800",
            "fax_number": "201-387-2248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERGEN SPINE & REHABILITATION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-21",
        "last_updated": "2009-02-04",
        "status": "A",
        "authorized_official_last_name": "POLLER",
        "authorized_official_first_name": "WAYNE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "201-387-2800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111NX0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Occupational Health",
            "state": "NJ",
            "license": "MC02082",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Poller Chiropractic Center",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• BBZ Limousine & Livery Service, Inc.
• Rachel N/a Beitler
• Payam Benson, MD
• Bergen Dental Practice, P.C.
• Bergen Pediatric Center,P.C
• Bergen Spine Sport & Rehab LLC
• Bergenfield Board of Education
• Bergenfield Dental Associates
• Bergenfield Gynecology & Wellness LLC
• Bergenfield Internal Medicine, L.L.C.

• Occupational Health Chiropractor in Bergenfield, NJ
• Providers in Bergenfield, NJ by specialty
• Occupational Health Chiropractor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2009; 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.