| NPI | 1477697795 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISE JACKSON Administrative Assistant 856-489-9822 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NJ 25MB04930000) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NJ 25MB04736200) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NJ 25MA06259700) | |
| Enumeration Date | 2007-02-19 |
| Last Update Date | 2018-05-15 |