Provider Demographics
NPI:1932469285
Name:ADVANCED REHABILITATION AND PAIN MEDICINE GROUP, INC.
Entity Type:Organization
Organization Name:ADVANCED REHABILITATION AND PAIN MEDICINE GROUP, INC.
Other - Org Name:ATLAS SPINE AND INTERVENTIONAL MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:P
Authorized Official - Last Name:WALDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-430-2022
Mailing Address - Street 1:8901 KENNEDY BLVD
Mailing Address - Street 2:SUITE 1W
Mailing Address - City:NORTH BERGEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07047-5344
Mailing Address - Country:US
Mailing Address - Phone:201-430-2022
Mailing Address - Fax:201-243-7261
Practice Address - Street 1:8901 KENNEDY BLVD
Practice Address - Street 2:SUITE 1W
Practice Address - City:NORTH BERGEN
Practice Address - State:NJ
Practice Address - Zip Code:07047-5344
Practice Address - Country:US
Practice Address - Phone:201-430-2022
Practice Address - Fax:201-243-7261
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-21
Last Update Date:2015-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07732700208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty