Provider Demographics
NPI:1275013534
Name:SPR INSTITUTE
Entity Type:Organization
Organization Name:SPR INSTITUTE
Other - Org Name:SPORTS PAIN & REGENERATIVE INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:DR
Authorized Official - First Name:HARSHVARDHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAOBAL
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:201-402-7802
Mailing Address - Street 1:143 ANDERSON AVE
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW
Mailing Address - State:NJ
Mailing Address - Zip Code:07022-2001
Mailing Address - Country:US
Mailing Address - Phone:201-654-6397
Mailing Address - Fax:
Practice Address - Street 1:143 ANDERSON AVE
Practice Address - Street 2:
Practice Address - City:FAIRVIEW
Practice Address - State:NJ
Practice Address - Zip Code:07022-2001
Practice Address - Country:US
Practice Address - Phone:201-654-6397
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-16
Last Update Date:2021-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty