| NPI | 1720592942 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMYADEV DATTA Owner 201-525-0002 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NJ 25MA07161100) |
| Enumeration Date | 2017-11-27 |
| Last Update Date | 2018-05-10 |