Provider Demographics
NPI:1134420813
Name:NEW JERSEY ADVANCED PAIN MANAGEMENT CENTER
Entity type:Organization
Organization Name:NEW JERSEY ADVANCED PAIN MANAGEMENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AJAY
Authorized Official - Middle Name:
Authorized Official - Last Name:KUMAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-917-3800
Mailing Address - Street 1:1081 PARSIPPANY BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:PARSIPPANY
Mailing Address - State:NJ
Mailing Address - Zip Code:07054-1291
Mailing Address - Country:US
Mailing Address - Phone:973-917-3800
Mailing Address - Fax:
Practice Address - Street 1:1081 PARSIPPANY BLVD STE 102
Practice Address - Street 2:
Practice Address - City:PARSIPPANY
Practice Address - State:NJ
Practice Address - Zip Code:07054-1291
Practice Address - Country:US
Practice Address - Phone:973-917-3800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-11
Last Update Date:2014-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA078772002081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Single Specialty