Provider Demographics
NPI:1275564445
Name:INTERVENTIONAL PAIN ASSOCIATES
Entity Type:Organization
Organization Name:INTERVENTIONAL PAIN ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:KAUL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-248-8818
Mailing Address - Street 1:PO BOX 378
Mailing Address - Street 2:
Mailing Address - City:POMPTON LAKES
Mailing Address - State:NJ
Mailing Address - Zip Code:07442
Mailing Address - Country:US
Mailing Address - Phone:973-248-8818
Mailing Address - Fax:973-248-8848
Practice Address - Street 1:111 WANAQUE AVE
Practice Address - Street 2:
Practice Address - City:POMPTON LAKES
Practice Address - State:NJ
Practice Address - Zip Code:07442
Practice Address - Country:US
Practice Address - Phone:973-248-8818
Practice Address - Fax:973-248-8844
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty