Provider Demographics
NPI:1073857256
Name:NASPAC-NJ PLLC
Entity Type:Organization
Organization Name:NASPAC-NJ PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HENNIGAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-947-7992
Mailing Address - Street 1:1800 BYBERRY RD
Mailing Address - Street 2:SUITE 1101
Mailing Address - City:HUNTINGDON VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19006-3518
Mailing Address - Country:US
Mailing Address - Phone:215-947-7992
Mailing Address - Fax:215-947-7969
Practice Address - Street 1:495 THOMAS JONES WAY
Practice Address - Street 2:SUITE 304
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-2553
Practice Address - Country:US
Practice Address - Phone:215-947-7992
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-12
Last Update Date:2012-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty