Provider Demographics
NPI:1265619928
Name:NJ SPINE AND PAIN CENTER INC
Entity type:Organization
Organization Name:NJ SPINE AND PAIN CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:UDAY
Authorized Official - Middle Name:N
Authorized Official - Last Name:BHATT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-587-6070
Mailing Address - Street 1:2111 KLOCKNER RD
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08690-3403
Mailing Address - Country:US
Mailing Address - Phone:609-587-6070
Mailing Address - Fax:609-587-6010
Practice Address - Street 1:2111 KLOCKNER RD
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08690-3403
Practice Address - Country:US
Practice Address - Phone:609-587-6070
Practice Address - Fax:609-587-6010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-24
Last Update Date:2008-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MAO80130002081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Single Specialty