Provider Demographics
NPI:1851753008
Name:BCT PAIN MANAGEMENT.LLC
Entity Type:Organization
Organization Name:BCT PAIN MANAGEMENT.LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BAO CHAU
Authorized Official - Middle Name:M
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-718-3165
Mailing Address - Street 1:285 DURHAM AVE
Mailing Address - Street 2:A2
Mailing Address - City:SOUTH PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07080-2546
Mailing Address - Country:US
Mailing Address - Phone:732-718-3165
Mailing Address - Fax:
Practice Address - Street 1:285 DURHAM AVE
Practice Address - Street 2:A2
Practice Address - City:SOUTH PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07080-2546
Practice Address - Country:US
Practice Address - Phone:732-718-3165
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-27
Last Update Date:2016-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08559100207LP2900X
NJ25MD00293500213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ020756Medicare PIN