Provider Demographics
NPI:1265644363
Name:TOTOWA CENTER FOR PAIN MANAGEMENT & PHYSICAL MEDICINE,P.C.
Entity Type:Organization
Organization Name:TOTOWA CENTER FOR PAIN MANAGEMENT & PHYSICAL MEDICINE,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CLAUDIA
Authorized Official - Middle Name:
Authorized Official - Last Name:NIEVES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-720-1700
Mailing Address - Street 1:290 UNION BLVD STE 1
Mailing Address - Street 2:
Mailing Address - City:TOTOWA
Mailing Address - State:NJ
Mailing Address - Zip Code:07512-2610
Mailing Address - Country:US
Mailing Address - Phone:973-720-1700
Mailing Address - Fax:973-720-1701
Practice Address - Street 1:290 UNION BLVD STE 1
Practice Address - Street 2:
Practice Address - City:TOTOWA
Practice Address - State:NJ
Practice Address - Zip Code:07512-2610
Practice Address - Country:US
Practice Address - Phone:973-720-1700
Practice Address - Fax:973-720-1701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ030581Medicare PIN