Provider Demographics
NPI:1922480078
Name:PRINCETON PAIN & SPINE INSTITUTE PC
Entity Type:Organization
Organization Name:PRINCETON PAIN & SPINE INSTITUTE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DINASH
Authorized Official - Middle Name:
Authorized Official - Last Name:YANAMADULA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-512-1690
Mailing Address - Street 1:123 FRANKLIN CORNER RD STE 104
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08648-2526
Mailing Address - Country:US
Mailing Address - Phone:609-512-1690
Mailing Address - Fax:609-512-1674
Practice Address - Street 1:123 FRANKLIN CORNER RD STE 104
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648-2526
Practice Address - Country:US
Practice Address - Phone:609-512-1690
Practice Address - Fax:609-512-1674
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-25
Last Update Date:2015-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site