| NPI | 1669870689 |
|---|---|
| Doing Business As | IVY LEAGUE PAIN MANAGEMENT CENTER |
| Entity Type | Organization |
| Authorized Contact | JORGE G. MENDEZ President 908-255-6200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NJ 25MA08542000) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MA08542000) |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2014-12-08 |
| Last Update Date | 2019-03-13 |