Provider Demographics
NPI:1740721851
Name:SOMERSET PAIN & ORTHOPEDIC REHABILITATION, LLC
Entity type:Organization
Organization Name:SOMERSET PAIN & ORTHOPEDIC REHABILITATION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HR DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LEIGH
Authorized Official - Middle Name:J
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-252-0242
Mailing Address - Street 1:399 CAMPUS DR
Mailing Address - Street 2:SUITE 110
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-1168
Mailing Address - Country:US
Mailing Address - Phone:732-993-6050
Mailing Address - Fax:732-497-4462
Practice Address - Street 1:399 CAMPUS DR
Practice Address - Street 2:SUITE 110
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-1168
Practice Address - Country:US
Practice Address - Phone:732-993-6050
Practice Address - Fax:732-497-4462
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-09
Last Update Date:2017-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No111NN0400XChiropractic ProvidersChiropractorNeurologyGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty