| Spine And Sports Medicine Of Barnegat Llc | |
|
175 Gunning River Rd, Building D, Barnegat, NJ 08005-1436 | |
| (732) 714-0070 | |
| Not Available |
| Full Name | Spine And Sports Medicine Of Barnegat Llc |
|---|---|
| Type | Facility |
| Speciality | Physical Medicine & Rehabilitation - Pain Medicine |
| Location | 175 Gunning River Rd, Barnegat, New Jersey |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003154519 | NPI | - | NPPES |
| 1811010549 | Other | NJ | NPI NUMBER |
| 1760519102 | Other | NJ | NPI NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | 38MC00577500 (New Jersey) | Secondary |
| 2081P2900X | Physical Medicine & Rehabilitation - Pain Medicine | (* (Not Available)) | Primary |
| Provider Name | James Kirk |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1760519102 PECOS PAC ID: 0840253837 Enrollment ID: I20041110000792 |
| Provider Name | Xin Liu |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1538309059 PECOS PAC ID: 8820148216 Enrollment ID: I20090605000016 |
| Provider Name | Kevin Hsu |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1477740751 PECOS PAC ID: 1153496203 Enrollment ID: I20090909000202 |
| Provider Name | Nicole Fullaway |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1235442690 PECOS PAC ID: 8426245028 Enrollment ID: I20101208000989 |
| Provider Name | Dimitrios Lambrou |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1184684482 PECOS PAC ID: 1254431695 Enrollment ID: I20120327000830 |
| Provider Name | Arturo Villanueva |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1689921132 PECOS PAC ID: 4183943962 Enrollment ID: I20150428002159 |
| Provider Name | Michael Ra |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1619132123 PECOS PAC ID: 1355658873 Enrollment ID: I20150916001744 |
| Provider Name | Kathrine A Orlando |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1366997280 PECOS PAC ID: 9830462621 Enrollment ID: I20170830000072 |
| Provider Name | Madelyn Black |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1356079065 PECOS PAC ID: 6507241395 Enrollment ID: I20220914003115 |
| Provider Name | Gabrielle Nicole Sorrentino |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1558019463 PECOS PAC ID: 4284009044 Enrollment ID: I20230407001975 |
| Provider Name | Eliza Osborne |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1902581077 PECOS PAC ID: 6901266451 Enrollment ID: I20230717001309 |
| Mailing Address | Practice Location Address |
|---|---|
| Spine And Sports Medicine Of Barnegat Llc 175 Gunning River Rd Bldg D, Barnegat, NJ 08005-1436 Ph: (609) 660-0002 | Spine And Sports Medicine Of Barnegat Llc 175 Gunning River Rd, Building D, Barnegat, NJ 08005-1436 Ph: (732) 714-0070 |