Healthcare Provider Details

I. General information

NPI: 1093363335
Provider Name (Legal Business Name): NORTH AMERICAN SPINE & PAIN CONSULTANTS LLC NASPAC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2019
Last Update Date: 08/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 GLASGOW AVE STE 126
NEWARK DE
19702-4777
US

IV. Provider business mailing address

404 CREEK CROSSING BLVD STE 404
HAINESPORT NJ
08036-2768
US

V. Phone/Fax

Practice location:
  • Phone: 302-439-3063
  • Fax: 302-439-3321
Mailing address:
  • Phone: 609-845-3988
  • Fax: 609-288-6078

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: SANJAY CHEULKAR
Title or Position: COO
Credential:
Phone: 609-410-9424