Healthcare Provider Details

I. General information

NPI: 1295131175
Provider Name (Legal Business Name): ABSOLUTE INTERVENTIONAL PAIN MEDICINE AND REHAB PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/05/2014
Last Update Date: 02/21/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1317 BOUND BROOK ROAD
MIDDLESEX NJ
08846
US

IV. Provider business mailing address

1317 BOUND BROOK ROAD
MIDDLESEX NJ
08846
US

V. Phone/Fax

Practice location:
  • Phone: 732-748-9944
  • Fax: 732-748-0800
Mailing address:
  • Phone: 732-748-9944
  • Fax: 732-748-0800

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. SAM RAHAT
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 347-683-3008