Provider Demographics
NPI:1093100265
Name:PAIN MANAGEMENT ASSOCIATES OF CENTRAL JERSEY, P. C.
Entity Type:Organization
Organization Name:PAIN MANAGEMENT ASSOCIATES OF CENTRAL JERSEY, P. C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:MANOJ
Authorized Official - Middle Name:D
Authorized Official - Last Name:PATHARKAR
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:732-549-9049
Mailing Address - Street 1:3840 PARK AVE
Mailing Address - Street 2:STE 102A
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-2563
Mailing Address - Country:US
Mailing Address - Phone:732-549-9049
Mailing Address - Fax:732-549-3493
Practice Address - Street 1:3840 PARK AVE
Practice Address - Street 2:STE 102A
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-2563
Practice Address - Country:US
Practice Address - Phone:732-549-9049
Practice Address - Fax:732-549-3493
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-03
Last Update Date:2015-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07439500174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty