Provider Demographics
NPI:1457011215
Name:NJ INSTITUTE FOR PAIN RELIEF
Entity Type:Organization
Organization Name:NJ INSTITUTE FOR PAIN RELIEF
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:PASQUALE
Authorized Official - Middle Name:
Authorized Official - Last Name:PUCCIARELLI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:908-474-9444
Mailing Address - Street 1:901 N WOOD AVE
Mailing Address - Street 2:
Mailing Address - City:LINDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07036-4039
Mailing Address - Country:US
Mailing Address - Phone:908-474-9444
Mailing Address - Fax:908-275-8454
Practice Address - Street 1:901 N WOOD AVE
Practice Address - Street 2:
Practice Address - City:LINDEN
Practice Address - State:NJ
Practice Address - Zip Code:07036-4039
Practice Address - Country:US
Practice Address - Phone:908-474-9444
Practice Address - Fax:908-275-8454
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-21
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty