Healthcare Provider Details

I. General information

NPI: 1023751104
Provider Name (Legal Business Name): PREMIER PAIN & ANESTHESIA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2022
Last Update Date: 07/26/2022
Certification Date: 07/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 WESCOTT DR
FLEMINGTON NJ
08822-4603
US

IV. Provider business mailing address

7 WILLIAM MARTIN WAY
FLEMINGTON NJ
08822-1300
US

V. Phone/Fax

Practice location:
  • Phone: 908-788-6410
  • Fax:
Mailing address:
  • Phone: 315-271-9422
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SAMEER A SIDDIQI
Title or Position: OWNER
Credential: DO
Phone: 315-271-9422