Provider Demographics
NPI:1073996641
Name:BIMODAL PAIN MANAGEMENT
Entity Type:Organization
Organization Name:BIMODAL PAIN MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ION
Authorized Official - Middle Name:VIOREL
Authorized Official - Last Name:PANCU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:551-574-3661
Mailing Address - Street 1:1425 GARDEN ST APT 604
Mailing Address - Street 2:
Mailing Address - City:HOBOKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07030-4592
Mailing Address - Country:US
Mailing Address - Phone:551-574-3661
Mailing Address - Fax:
Practice Address - Street 1:1425 GARDEN ST
Practice Address - Street 2:APT.604
Practice Address - City:HOBOKEN
Practice Address - State:NJ
Practice Address - Zip Code:07030-4477
Practice Address - Country:US
Practice Address - Phone:551-574-3661
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-01
Last Update Date:2015-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty