Provider Demographics
NPI:1689713976
Name:PAIN MANAGEMENT CONSULTING GROUP
Entity Type:Organization
Organization Name:PAIN MANAGEMENT CONSULTING GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ABDEL RAHMAN
Authorized Official - Middle Name:SAYED
Authorized Official - Last Name:BAKHATY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-217-6822
Mailing Address - Street 1:PO BOX 3485
Mailing Address - Street 2:
Mailing Address - City:SECAUCUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07094
Mailing Address - Country:US
Mailing Address - Phone:201-217-6822
Mailing Address - Fax:201-217-6899
Practice Address - Street 1:3200 KENNEDY BOULEVARD
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-3416
Practice Address - Country:US
Practice Address - Phone:201-217-6822
Practice Address - Fax:201-217-6899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA042237207LP2900X
NJMA044176207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty