Provider Demographics
NPI:1215230321
Name:PAIN SPECIALISTS OF NEW YORK AND NEW JERSEY LLC
Entity Type:Organization
Organization Name:PAIN SPECIALISTS OF NEW YORK AND NEW JERSEY LLC
Other - Org Name:NORTHEAST ANESTHESIA & PAIN MANAGEMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANSON
Authorized Official - Middle Name:M
Authorized Official - Last Name:MOISE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:1201-871-4000
Mailing Address - Street 1:54 SOUTH DEAN STREET
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631
Mailing Address - Country:US
Mailing Address - Phone:201-871-4000
Mailing Address - Fax:201-568-6851
Practice Address - Street 1:54 SOUTH DEAN STREET
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631
Practice Address - Country:US
Practice Address - Phone:201-871-4000
Practice Address - Fax:201-568-6851
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-10
Last Update Date:2011-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty