Provider Demographics
NPI:1821412867
Name:METROPOLITAN PAIN & REHABILITATION CENTER, LLC
Entity Type:Organization
Organization Name:METROPOLITAN PAIN & REHABILITATION CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:DIDIER
Authorized Official - Middle Name:A
Authorized Official - Last Name:DEMESMIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:646-373-8463
Mailing Address - Street 1:PO BOX 10827
Mailing Address - Street 2:
Mailing Address - City:NEW BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08906-0827
Mailing Address - Country:US
Mailing Address - Phone:732-565-1701
Mailing Address - Fax:732-565-1710
Practice Address - Street 1:71 LIVINGSTON AVE
Practice Address - Street 2:
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901-2523
Practice Address - Country:US
Practice Address - Phone:732-565-1701
Practice Address - Fax:732-565-1710
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-11
Last Update Date:2014-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty