Provider Demographics
NPI:1740904440
Name:ATLANTIC SPINE AND JOINT PAIN CENTER
Entity type:Organization
Organization Name:ATLANTIC SPINE AND JOINT PAIN CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:ALEXEEV
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-385-5537
Mailing Address - Street 1:200 CRAIG RD STE 118
Mailing Address - Street 2:
Mailing Address - City:MANALAPAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726-8735
Mailing Address - Country:US
Mailing Address - Phone:732-385-5537
Mailing Address - Fax:732-538-1614
Practice Address - Street 1:200 CRAIG RD STE 118
Practice Address - Street 2:
Practice Address - City:MANALAPAN
Practice Address - State:NJ
Practice Address - Zip Code:07726-8735
Practice Address - Country:US
Practice Address - Phone:732-385-5537
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-27
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty