Provider Demographics
NPI:1376124115
Name:CENTER FOR SPINE AND JOINT PAIN RELIEF LLC
Entity Type:Organization
Organization Name:CENTER FOR SPINE AND JOINT PAIN RELIEF LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DHARAM
Authorized Official - Middle Name:PAL
Authorized Official - Last Name:MANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-849-0077
Mailing Address - Street 1:1100 RT 70 WEST
Mailing Address - Street 2:
Mailing Address - City:WHITING
Mailing Address - State:NJ
Mailing Address - Zip Code:08759-1003
Mailing Address - Country:US
Mailing Address - Phone:732-202-3000
Mailing Address - Fax:732-849-1511
Practice Address - Street 1:1314 HOOPER AVENUE BUILDING B 1ST FLOOR
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-2586
Practice Address - Country:US
Practice Address - Phone:732-202-3000
Practice Address - Fax:732-849-1511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-14
Last Update Date:2021-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty