EXECUTIVE SPINE SURGERY
NPI 1063968360
Neurological Surgery in Hackettstown, NJ

Active since August 28, 2016
657 WILLOW GROVE ST STE 402, HACKETTSTOWN, NJ 07840(908) 452-5612 Get Directions Write a Review

NPPES record last updated: August 28, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Executive Spine Surgery NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EXECUTIVE SPINE SURGERY (NPI 1063968360) is a healthcare organization registered as a neurological surgery in Hackettstown, New Jersey and active in the NPI registry since August 2016. The organization lists Carl J Spivak, Neurosurgeon, as its authorized official.

NPPES Registry Identity

NPI1063968360
Entity TypeOrganization
Primary Taxonomy207T00000X
Legal Business NameEXECUTIVE SPINE SURGERY
Location Address657 WILLOW GROVE ST STE 402Hackettstown, NJ 07840
Mailing Address657 Willow Grove St Ste 402Hackettstown, NJ 07840-1868 · (908) 452-5612
Organization SubpartNo
Authorized OfficialCarl J SpivakNeurosurgeon · (908) 452-5612
Enumeration DateAugust 28, 2016
NPI 1063968360 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNeurological SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207T00000X
License Licensed in NY · 003005
Definition
A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution.
657 WILLOW GROVE ST STE 402, Hackettstown, NJ 07840

Other Identifiers 1

Medicare UPINRB7234NY

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Executive Spine Surgery's NPI number?

The NPI number for Executive Spine Surgery is 1063968360. It was assigned to this organization in the NPPES registry on August 28, 2016.

Where is Executive Spine Surgery located?

Executive Spine Surgery is located at 657 Willow Grove St Ste 402, Hackettstown, NJ 07840. The listed phone number is (908) 452-5612.

What is Executive Spine Surgery's specialty?

The primary specialty registered for this NPI is Neurological Surgery with taxonomy code 207T00000X.

When was this NPI record last updated?

The NPPES record for Executive Spine Surgery was last updated on August 28, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.