Provider Demographics
NPI:1205373669
Name:TRISTATE PAIN AND SPINE MANAGEMENT LLC
Entity Type:Organization
Organization Name:TRISTATE PAIN AND SPINE MANAGEMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAJAT
Authorized Official - Middle Name:
Authorized Official - Last Name:SEKHAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:646-875-1174
Mailing Address - Street 1:57 RACHEL CT
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:08823-1542
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:28 COURTSIDE LN
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-9504
Practice Address - Country:US
Practice Address - Phone:609-891-9984
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-24
Last Update Date:2017-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA09282300207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty