Provider Demographics
NPI:1659140044
Name:PAIN CONTROL CENTER OF NEW JERSEY LLC
Entity Type:Organization
Organization Name:PAIN CONTROL CENTER OF NEW JERSEY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AO
Authorized Official - Prefix:
Authorized Official - First Name:AMARJIT
Authorized Official - Middle Name:
Authorized Official - Last Name:VIRDI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:734-716-1632
Mailing Address - Street 1:561 CRANBURY RD
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-5400
Mailing Address - Country:US
Mailing Address - Phone:732-651-1300
Mailing Address - Fax:
Practice Address - Street 1:561 CRANBURY RD
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-5400
Practice Address - Country:US
Practice Address - Phone:732-651-1300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-27
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty