Provider Demographics
NPI:1205137528
Name:NJ ORTHOPEDIC REHAB AND PAIN MANAGEMENT GROUP PC
Entity type:Organization
Organization Name:NJ ORTHOPEDIC REHAB AND PAIN MANAGEMENT GROUP PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:R
Authorized Official - Last Name:ADIN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:732-527-0770
Mailing Address - Street 1:291 AMBOY AVE
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07095-2805
Mailing Address - Country:US
Mailing Address - Phone:732-527-0770
Mailing Address - Fax:732-218-5872
Practice Address - Street 1:291 AMBOY AVE
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07095-2805
Practice Address - Country:US
Practice Address - Phone:732-527-0770
Practice Address - Fax:732-218-5872
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-04
Last Update Date:2010-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMB080323002081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Multi-Specialty