Provider Demographics
NPI:1982743852
Name:BACK & NECK PAIN ASSOCIATES
Entity Type:Organization
Organization Name:BACK & NECK PAIN ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GAETANO
Authorized Official - Middle Name:
Authorized Official - Last Name:BUTTITTA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:201-599-2505
Mailing Address - Street 1:120 N STATE RT 17 STE 126
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-2812
Mailing Address - Country:US
Mailing Address - Phone:201-599-2505
Mailing Address - Fax:201-599-3805
Practice Address - Street 1:120 N STATE RT 17 STE 126
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-2812
Practice Address - Country:US
Practice Address - Phone:201-599-2505
Practice Address - Fax:201-599-3805
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC 046068111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
=========OtherEIN