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

Executive Spine Surgery PC

Organization Neurological Surgery Physician · NPI 1164789582

Executive Spine Surgery PC is a Neurological Surgery Physician in Newton, New Jersey. Licensed in New Jersey. Registered with an NPI since 2012.

Licensed in
NJ
In the registry since
2012
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

157 High St
Newton, NJ 07860-1004
Phone: (908) 452-5612
Fax: (908) 452-5624
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 25MA09005200 (NJ)

Record details

NPI number1164789582
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Irina Kamenetskiy — Adminitrator · (917) 697-5558
NPI enumeratedApril 23, 2012
Last updated in NPPESFebruary 9, 2021
Certification dateFebruary 9, 2021
Mailing address157 High St, Newton, NJ 07860-1004

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