Healthcare Provider Details

I. General information

NPI: 1093308348
Provider Name (Legal Business Name): HIGHLAND MEDICAL & REGENERATIVE MEDICINE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/18/2021
Last Update Date: 02/18/2021
Certification Date: 02/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 HERRON RD
EDISON NJ
08820-3007
US

IV. Provider business mailing address

5 HERRON RD
EDISON NJ
08820-3007
US

V. Phone/Fax

Practice location:
  • Phone: 914-376-6100
  • Fax: 914-470-5056
Mailing address:
  • Phone: 914-376-6100
  • Fax: 914-470-5056

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P2900X
TaxonomyPain Medicine (Psychiatry & Neurology) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State

VIII. Authorized Official

Name: SONALI LAL
Title or Position: OWNER
Credential: MD
Phone: 914-376-6100