Provider Demographics
NPI:1992009849
Name:HAMILTON PAIN AND REHAB ASSOCIATES
Entity Type:Organization
Organization Name:HAMILTON PAIN AND REHAB ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:DIPASTINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-392-7510
Mailing Address - Street 1:PO BOX 55845
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08638-6845
Mailing Address - Country:US
Mailing Address - Phone:609-394-5111
Mailing Address - Fax:609-482-4972
Practice Address - Street 1:2141 BRUNSWICK PIKE
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648
Practice Address - Country:US
Practice Address - Phone:609-394-5111
Practice Address - Fax:609-482-4972
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-07
Last Update Date:2011-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA070640174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ25MA070640OtherLICENSE#