Provider Demographics
NPI:1447597638
Name:PRECISION PAIN MANAGEMENT, LLC
Entity Type:Organization
Organization Name:PRECISION PAIN MANAGEMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:A
Authorized Official - Last Name:COCCARO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:098-216-1097
Mailing Address - Street 1:300 W WATER ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-6692
Mailing Address - Country:US
Mailing Address - Phone:908-810-6726
Mailing Address - Fax:
Practice Address - Street 1:300 W WATER ST
Practice Address - Street 2:SUITE A
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-6692
Practice Address - Country:US
Practice Address - Phone:908-810-6726
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-09
Last Update Date:2016-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06552700207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty