Provider Demographics
NPI:1821156308
Name:NORTH JERSEY PAIN MANAGEMENT CENTER,LLC.
Entity Type:Organization
Organization Name:NORTH JERSEY PAIN MANAGEMENT CENTER,LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LADISLAV
Authorized Official - Middle Name:
Authorized Official - Last Name:HABINA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-464-3341
Mailing Address - Street 1:3 FOX BORO RD
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-8442
Mailing Address - Country:US
Mailing Address - Phone:973-464-3341
Mailing Address - Fax:973-357-4998
Practice Address - Street 1:3 FOX BORO RD
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-8442
Practice Address - Country:US
Practice Address - Phone:973-464-3341
Practice Address - Fax:973-357-4998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ261QP3300X261QP3300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain