COASTAL SPINE PC NPI 1417985094

NPI Information

  • NPI: 1417985094
  • Provider Name: COASTAL SPINE PC
  • Classification: Orthopaedic Surgery - 207XS0117X
  • Specialization: Orthopaedic Surgery of the Spine
  • Entity Type: Organization
  • CLIA Number: 31D2090807
  • Address: 4000 CHURCH RD
    MOUNT LAUREL, NJ
    ZIP 08054
  • Phone: (856) 222-4444

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NPI Details

COASTAL SPINE PC is an orthopaedic surgery of the spine orthopaedic surgery in Mount Laurel, NJ. The provider is recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, orthopaedic surgeons of the spine deal with the evaluation and nonoperative and operative treatment of the full spectrum of primary spinal disorders including trauma, degenerative, deformity, tumor, and reconstructive. COASTAL SPINE PC NPI is 1417985094. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

4000 CHURCH RD
MOUNT LAUREL, NJ
ZIP 08054-110
Phone: (856) 222-4444

The provider's authorized official is Marguerite Zoltek .
The authorized official title is Billing Director and has the following contact phone number (856) 222-4444.

The CLIA number assigned to this NPI record is 31D2090807 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/30/2006 and was last updated on 1/21/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207XS0117XOrthopaedic SurgeryOrthopaedic Surgery of the SpineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
15511390001MEDICARE NSCNEW JERSEY
2069103MEDICARE PINNEW JERSEY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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