| NPI | 1962796664 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXANDER VEDER Medical Director 646-522-3664 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NJ 25MA08899900) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MA08792700) |
| 207QG0300X Family Medicine, Geriatric Medicine (Licence: NJ 25MA08792700) | |
| 207QS0010X Family Medicine, Sports Medicine (Licence: NJ 25MA08792700) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: NJ 25MA08899900) | |
| 208VP0000X (Licence: NJ 25MA08899900) | |
| 207QA0000X Family Medicine, Adolescent Medicine (Licence: NJ 25MA08792700) | |
| 207QA0505X Family Medicine, Adult Medicine (Licence: NJ 25MA08792700) | |
| Enumeration Date | 2011-05-31 |
| Last Update Date | 2011-10-26 |