| Advanced Spine Care And Physical Rehabilitation,llc | |
|
728 Bennetts Mills Rd Suite 1 Jackson NJ 08527-3850 | |
| (732) 415-1401 | |
| (732) 415-1403 |
| Full Name | Advanced Spine Care And Physical Rehabilitation,llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 728 Bennetts Mills Rd, Jackson, New Jersey |
| Authorized Official Name and Position | Lambros R. Lambrou (OWNER) |
| Authorized Official Contact | 7324151401 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Spine Care And Physical Rehabilitation,llc 728 Bennetts Mills Rd Suite 1 Jackson NJ 08527-3850 Ph: (732) 415-1401 | Advanced Spine Care And Physical Rehabilitation,llc 728 Bennetts Mills Rd Suite 1 Jackson NJ 08527-3850 Ph: (732) 415-1401 |
| NPI Number | 1891816914 |
|---|---|
| Provider Enumeration Date | 04/03/2007 |
| Last Update Date | 03/25/2024 |
| Medicare PECOS PAC ID | 0749269637 |
|---|---|
| Medicare Enrollment ID | O20040715000057 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891816914 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | MC05652 (New Jersey) | Primary |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 7427430001 (New Jersey) | Secondary |
| Provider Name | Lambros R Lambrou |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1235108838 PECOS PAC ID: 9830178730 Enrollment ID: I20040720000026 |
| Provider Name | Rejane M Bambo |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1851510028 PECOS PAC ID: 0547299778 Enrollment ID: I20050815000259 |
| Provider Name | Alexis Greenberg |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1184656985 PECOS PAC ID: 0648280107 Enrollment ID: I20060427000508 |
| Provider Name | Edward K Rodriguez |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1659595627 PECOS PAC ID: 7719059294 Enrollment ID: I20080627000092 |
| Provider Name | Stacey Franz |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1306018668 PECOS PAC ID: 4789757212 Enrollment ID: I20080717000036 |
| 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 | Dustin C Fullaway |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1346553807 PECOS PAC ID: 9931395225 Enrollment ID: I20101129000801 |
| Provider Name | Alan Guy |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1275859217 PECOS PAC ID: 5092954503 Enrollment ID: I20141003000215 |
| 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 | Bobbi A Dorio |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1699908566 PECOS PAC ID: 2668776741 Enrollment ID: I20160210001327 |
| Provider Name | Kellyann Gross |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932623881 PECOS PAC ID: 7719252303 Enrollment ID: I20171007000278 |
| Provider Name | Michael J Verde |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1891910832 PECOS PAC ID: 2567693583 Enrollment ID: I20181113001276 |
| Provider Name | Magdalene F Hanna |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1346718624 PECOS PAC ID: 0244576460 Enrollment ID: I20190109001785 |
| Provider Name | Erin M Glorioso |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1245877539 PECOS PAC ID: 1850726076 Enrollment ID: I20200116001673 |
| Provider Name | Taylor Lynn Daton |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1588269344 PECOS PAC ID: 1850703315 Enrollment ID: I20201208000537 |
| Provider Name | Jessica N D'angelo |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1790397289 PECOS PAC ID: 9931511268 Enrollment ID: I20201210001314 |
| Provider Name | Kaley Marie Stinson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1790405959 PECOS PAC ID: 5698150126 Enrollment ID: I20220919002573 |
| Provider Name | Kimberly Hermoza |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1679296636 PECOS PAC ID: 7416323431 Enrollment ID: I20221017001967 |
| Provider Name | Bethany Joy Lin |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1275243586 PECOS PAC ID: 6103297858 Enrollment ID: I20230117002849 |
| Provider Name | Connor P Mcglynn |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1427756063 PECOS PAC ID: 9830564152 Enrollment ID: I20230418002289 |
| Provider Name | Roy Taborda |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1780188425 PECOS PAC ID: 7911367438 Enrollment ID: I20230717000041 |
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