Provider Demographics
NPI:1780338947
Name:OCEANFRONT PAIN MANAGEMENT AND SPORTS MEDICINE PLLC
Entity type:Organization
Organization Name:OCEANFRONT PAIN MANAGEMENT AND SPORTS MEDICINE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KINJAL
Authorized Official - Middle Name:B
Authorized Official - Last Name:SOHAGIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:757-500-2277
Mailing Address - Street 1:101 MEDFORD CT
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN
Mailing Address - State:VA
Mailing Address - Zip Code:23693-0012
Mailing Address - Country:US
Mailing Address - Phone:732-331-9626
Mailing Address - Fax:
Practice Address - Street 1:397 LITTLE NECK RD
Practice Address - Street 2:3300 NORTH BUILDING, SUITE 115
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452
Practice Address - Country:US
Practice Address - Phone:757-500-2277
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-07
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports MedicineGroup - Single Specialty
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Multi-Specialty
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty