Provider Demographics
NPI:1851728711
Name:ADVANCE PAIN MANAGEMENT LLC
Entity Type:Organization
Organization Name:ADVANCE PAIN MANAGEMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:PRAJAKTA
Authorized Official - Middle Name:V
Authorized Official - Last Name:AVHAD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-688-6866
Mailing Address - Street 1:1255 WHITEHORSE MERCERVILLE RD
Mailing Address - Street 2:SUITE-506
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08619-3800
Mailing Address - Country:US
Mailing Address - Phone:609-688-6866
Mailing Address - Fax:888-598-5388
Practice Address - Street 1:1255 WHITEHORSE MERCERVILLE RD
Practice Address - Street 2:SUITE- 506
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08619-3800
Practice Address - Country:US
Practice Address - Phone:609-688-6866
Practice Address - Fax:888-598-5388
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-08
Last Update Date:2013-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty