Provider Demographics
NPI:1891869475
Name:GARDEN STATE PAIN CONTROL CENTER P.A.
Entity Type:Organization
Organization Name:GARDEN STATE PAIN CONTROL CENTER P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BINOD
Authorized Official - Middle Name:P
Authorized Official - Last Name:SINHA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-777-5444
Mailing Address - Street 1:1117 US HIGHWAY 46
Mailing Address - Street 2:SUITE 206
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07013-2449
Mailing Address - Country:US
Mailing Address - Phone:973-777-5444
Mailing Address - Fax:973-777-0304
Practice Address - Street 1:1117 US HIGHWAY 46
Practice Address - Street 2:SUITE 206
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013-2449
Practice Address - Country:US
Practice Address - Phone:973-777-5444
Practice Address - Fax:973-777-0304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-17
Last Update Date:2011-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ792451Medicare ID - Type Unspecified
NJD06107Medicare UPIN