Provider Demographics
NPI:1912456831
Name:PREMIER PAIN AND REHABILITATION CENTER OF NJ PC
Entity Type:Organization
Organization Name:PREMIER PAIN AND REHABILITATION CENTER OF NJ PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:AJAY
Authorized Official - Middle Name:
Authorized Official - Last Name:KUMAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-917-3800
Mailing Address - Street 1:10 SUNRISE DR
Mailing Address - Street 2:
Mailing Address - City:PARSIPPANY
Mailing Address - State:NJ
Mailing Address - Zip Code:07054-4367
Mailing Address - Country:US
Mailing Address - Phone:973-917-3800
Mailing Address - Fax:973-206-2236
Practice Address - Street 1:7 RIDGEDALE AVE STE 204
Practice Address - Street 2:STE 204
Practice Address - City:CEDAR KNOLLS
Practice Address - State:NJ
Practice Address - Zip Code:07927-1120
Practice Address - Country:US
Practice Address - Phone:973-917-3800
Practice Address - Fax:973-206-2236
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-04
Last Update Date:2016-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Multi-Specialty
No111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Multi-Specialty