Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Executive Spine Surgery

Organization Neurological Surgery Physician · NPI 1063968360

Executive Spine Surgery is a Neurological Surgery Physician in Hackettstown, New Jersey. Licensed in New York. Registered with an NPI since 2016.

Licensed in
NY
In the registry since
2016

Practice location Address checks out

657 Willow Grove St Ste 402
Hackettstown, NJ 07840
Phone: (908) 452-5612
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Neurological Surgery Physician (primary) Taxonomy 207T00000X · Licence 003005 (NY)

Record details

NPI number1063968360
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Carl Spivak — Neurosurgeon · (908) 452-5612
NPI enumeratedAugust 28, 2016
Last updated in NPPESAugust 28, 2016
Mailing address657 Willow Grove St Ste 402, Hackettstown, NJ 07840-1868