Provider Demographics
NPI:1346276060
Name:PAIN CARE, P.C.
Entity Type:Organization
Organization Name:PAIN CARE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, PAIN CARE, P.C.
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:PETERSOHN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-926-3331
Mailing Address - Street 1:199 NEW RD
Mailing Address - Street 2:CENTRAL SQUARE SUITE 62-63
Mailing Address - City:LINWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08221-1325
Mailing Address - Country:US
Mailing Address - Phone:609-926-3331
Mailing Address - Fax:609-926-3350
Practice Address - Street 1:199 NEW RD
Practice Address - Street 2:CENTRAL SQUARE SUITE 62-63
Practice Address - City:LINWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08221-1325
Practice Address - Country:US
Practice Address - Phone:609-926-3331
Practice Address - Fax:609-926-3350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05788100207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ728465Medicare ID - Type UnspecifiedGROUP