Provider Demographics
NPI:1437272267
Name:PAINMED NJ LLC
Entity Type:Organization
Organization Name:PAINMED NJ LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:LALITHA
Authorized Official - Middle Name:
Authorized Official - Last Name:PIRATLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-249-3100
Mailing Address - Street 1:209 STATE ROUTE 18
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-1413
Mailing Address - Country:US
Mailing Address - Phone:732-249-3100
Mailing Address - Fax:732-249-7787
Practice Address - Street 1:209 STATE ROUTE 18
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-1413
Practice Address - Country:US
Practice Address - Phone:732-249-3100
Practice Address - Fax:732-249-7787
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06865600207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8469300Medicaid
1841390804OtherNPI
NJ8469300Medicaid