Provider Demographics
NPI:1033390471
Name:NORTH JERSEY INTERVENTIONAL PAIN, P.C.
Entity Type:Organization
Organization Name:NORTH JERSEY INTERVENTIONAL PAIN, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:ADIN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:516-739-3862
Mailing Address - Street 1:PO BOX 1915
Mailing Address - Street 2:
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-8415
Mailing Address - Country:US
Mailing Address - Phone:516-739-3862
Mailing Address - Fax:516-747-4783
Practice Address - Street 1:63 BEAVERBROOK RD
Practice Address - Street 2:204
Practice Address - City:LINCOLN PARK
Practice Address - State:NJ
Practice Address - Zip Code:07035-1440
Practice Address - Country:US
Practice Address - Phone:516-739-3862
Practice Address - Fax:516-747-4783
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-14
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMT7/QC107208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty