Provider Demographics
NPI:1922161470
Name:PAIN SPECIALISTS, PA
Entity Type:Organization
Organization Name:PAIN SPECIALISTS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MORRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:ANTEBI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-645-8884
Mailing Address - Street 1:1907 NEW RD
Mailing Address - Street 2:
Mailing Address - City:NORTHFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:08225-1544
Mailing Address - Country:US
Mailing Address - Phone:609-645-8884
Mailing Address - Fax:609-645-9780
Practice Address - Street 1:1907 NEW RD
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:NJ
Practice Address - Zip Code:08225-1544
Practice Address - Country:US
Practice Address - Phone:609-645-8884
Practice Address - Fax:609-645-9780
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-18
Last Update Date:2007-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJATS032OtherOXFORD
NJ183309OtherAETNA US HEALTHCARE
NJATS032OtherOXFORD
NJ183309OtherAETNA US HEALTHCARE