| NPI | 1710398144 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACKIE TATE Office Business Manager 732-451-1229 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NJ 65665) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 402a01520200) |
| 111N00000X Chiropractor (Licence: NJ 38mc00492900) | |
| 111N00000X Chiropractor (Licence: NJ 38MC00561500) | |
| 171100000X Acupuncturist (Licence: NJ 2MZ00010400) | |
| 225100000X Physical Therapist (Licence: NJ 40qa1371700) | |
| 207X00000X Orthopaedic Surgery (Licence: NJ 25MB06359800) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: NJ MA70679) | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: NJ 25MB09000000) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: NJ MA06926200) | |
| Enumeration Date | 2014-05-20 |
| Last Update Date | 2014-10-10 |