Provider Demographics
NPI:1417556614
Name:NORTHEAST PAIN & INJURY CENTER, LLC
Entity Type:Organization
Organization Name:NORTHEAST PAIN & INJURY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DIMITRIOS
Authorized Official - Middle Name:
Authorized Official - Last Name:LAMBROU
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:327-140-0070
Mailing Address - Street 1:1082 SAINT GEORGES AVE
Mailing Address - Street 2:
Mailing Address - City:RAHWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:07065-2664
Mailing Address - Country:US
Mailing Address - Phone:732-714-0070
Mailing Address - Fax:732-714-0188
Practice Address - Street 1:1082 SAINT GEORGES AVE
Practice Address - Street 2:
Practice Address - City:RAHWAY
Practice Address - State:NJ
Practice Address - Zip Code:07065-2664
Practice Address - Country:US
Practice Address - Phone:732-714-0070
Practice Address - Fax:732-714-0188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-20
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Multi-Specialty