Provider Demographics
NPI:1780872614
Name:D'AMATO, PAMELA R (MD)
Entity type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:R
Last Name:D'AMATO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 VALLEY RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-3534
Mailing Address - Country:US
Mailing Address - Phone:973-686-0700
Mailing Address - Fax:973-686-0701
Practice Address - Street 1:504 VALLEY RD
Practice Address - Street 2:SUITE 203
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-3534
Practice Address - Country:US
Practice Address - Phone:973-686-0700
Practice Address - Fax:973-686-0701
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-04
Last Update Date:2013-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08263200207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine