MEDICARE: INNOVATION ANESTHESIA & PAIN SERVICES, P C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208VP0014X	Interventional Pain Medicine Physician	25MA07744800	NJ

General Provider Information

NPI Number	:	1992175475
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INNOVATION ANESTHESIA & PAIN SERVICES, P C

Provider Business Mailing Address
First Line	:	294 LONG HILL DR
Second Line	:
City	:	SHORT HILLS
State	:	NJ
Zip	:	07078-1531
Country	:	US
Telephone Number	:	888-910-2800
Fax Number	:	201-943-8105

Provider Business Practice Location Address
First Line	:	294 LONG HILL DR
Second Line	:
City	:	SHORT HILLS
State	:	NJ
Zip	:	07078-1531
Country	:	US
Telephone Number	:	888-910-2800
Fax Number	:	201-943-8105

Authorized Official
Title or Position	:	SELF OWNER
Name	:	DONGHUI CHEN
Credential	:	M. D.
Telephone Number	:	973-906-0020

Provider Enumeration Date	:	09/28/2015
Last Update Date	:	09/28/2015

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