Provider Demographics
NPI:1003247388
Name:CHRONIC PAIN MANAGEMENT OF NEW JERSEY
Entity Type:Organization
Organization Name:CHRONIC PAIN MANAGEMENT OF NEW JERSEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR, OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:FLAXMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:347-804-8508
Mailing Address - Street 1:1930 ROUTE 70 EAST
Mailing Address - Street 2:SUITE N-70
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-4203
Mailing Address - Country:US
Mailing Address - Phone:856-581-9157
Mailing Address - Fax:856-581-9159
Practice Address - Street 1:1930 ROUTE 70 EAST
Practice Address - Street 2:SUITE N-70
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-4203
Practice Address - Country:US
Practice Address - Phone:856-581-9157
Practice Address - Fax:856-581-9159
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-11
Last Update Date:2013-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain