1205619574 NPI number — NJ SPINE AND BRAIN SURGERY

Table of content: DAWN MARIE STILL LLMSW (NPI 1881186047)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205619574 NPI number — NJ SPINE AND BRAIN SURGERY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NJ SPINE AND BRAIN SURGERY
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1205619574
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/09/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5341 ATLANTIC AVE STE 302
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DELRAY BEACH
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33484-8166
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
561-865-5431
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
375 MOUNT PLEASANT AVENUE
Provider Second Line Business Practice Location Address:
STE 205
Provider Business Practice Location Address City Name:
WEST ORANGE
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07052-2751
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
973-380-1140
Provider Business Practice Location Address Fax Number:
866-313-8923
Provider Enumeration Date:
08/18/2023

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SHETH
Authorized Official First Name:
RISHI
Authorized Official Middle Name:
N
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
973-380-1140

Provider Taxonomy Codes

  • Taxonomy code: 207T00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)