Provider Demographics
NPI:1568154128
Name:DR. STEFAN TRNOVSKI INTERVENTIONAL PAIN MANAGEMENT, LLC
Entity Type:Organization
Organization Name:DR. STEFAN TRNOVSKI INTERVENTIONAL PAIN MANAGEMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEFAN
Authorized Official - Middle Name:
Authorized Official - Last Name:TRNOVSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:862-377-7090
Mailing Address - Street 1:1373 BROAD ST STE 310
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07013-4231
Mailing Address - Country:US
Mailing Address - Phone:862-377-7090
Mailing Address - Fax:862-238-8228
Practice Address - Street 1:1373 BROAD ST STE 310
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013-4231
Practice Address - Country:US
Practice Address - Phone:862-377-7090
Practice Address - Fax:862-238-8228
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-23
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1447276704OtherORTOPEDIC SURGERY