Healthcare Provider Details

I. General information

NPI: 1356896245
Provider Name (Legal Business Name): PAIN CONTROL ASSOCIATES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2016
Last Update Date: 08/07/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2271 HIGHWAY 33 STE 103
HAMILTON NJ
08690-1749
US

IV. Provider business mailing address

2271 HIGHWAY 33 STE 103
HAMILTON NJ
08690-1749
US

V. Phone/Fax

Practice location:
  • Phone: 609-890-4080
  • Fax: 609-890-4090
Mailing address:
  • Phone: 609-890-4080
  • Fax: 609-890-4090

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number25MA05475100
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number25MA05475100
License Number StateNJ

VIII. Authorized Official

Name: MARC P. PLOTNICK
Title or Position: OWNER
Credential: MD
Phone: 609-744-7176