Healthcare Provider Details

I. General information

NPI: 1386924538
Provider Name (Legal Business Name): CENTRAL JERSEY PAIN INSTITUTE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2011
Last Update Date: 04/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 CORNWALL DRIVE SUITE A
EAST BRUNSWICK NJ
08816
US

IV. Provider business mailing address

3 CORNWALL DR SUITE A
EAST BRUNSWICK NJ
08816-3311
US

V. Phone/Fax

Practice location:
  • Phone: 732-698-1000
  • Fax: 732-698-1008
Mailing address:
  • Phone: 732-698-1000
  • Fax: 732-698-1008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP3300X
TaxonomyPain Clinic/Center
License Number25MA08812000
License Number StateNJ

VIII. Authorized Official

Name: MRS. FLORENCE RODRIGUES-AOUIZ
Title or Position: OFFICE MANAGER
Credential:
Phone: 732-698-1000