Provider Demographics
NPI:1437495637
Name:CENTER FOR PAIN AND SPINE CARE, LLC
Entity Type:Organization
Organization Name:CENTER FOR PAIN AND SPINE CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TERRANCE
Authorized Official - Middle Name:
Authorized Official - Last Name:WINN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-360-1800
Mailing Address - Street 1:3 HOSPITAL PLZ
Mailing Address - Street 2:SUITE 313
Mailing Address - City:OLD BRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:08857-3093
Mailing Address - Country:US
Mailing Address - Phone:732-360-1800
Mailing Address - Fax:908-810-1363
Practice Address - Street 1:3 HOSPITAL PLZ
Practice Address - Street 2:SUITE 313
Practice Address - City:OLD BRIDGE
Practice Address - State:NJ
Practice Address - Zip Code:08857-3093
Practice Address - Country:US
Practice Address - Phone:732-360-1800
Practice Address - Fax:908-810-1363
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-17
Last Update Date:2013-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA0708400100207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty