Healthcare Provider Details

I. General information

NPI: 1457717266
Provider Name (Legal Business Name): PAIN MANAGEMENT PHYSICIANS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2016
Last Update Date: 01/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

187 MILLBURN AVE STE 103
MILLBURN NJ
07041-1845
US

IV. Provider business mailing address

187 MILLBURN AVE STE 103
MILLBURN NJ
07041-1845
US

V. Phone/Fax

Practice location:
  • Phone: 973-467-1466
  • Fax: 973-467-1422
Mailing address:
  • Phone: 973-467-1466
  • Fax: 973-467-1422

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number25MA06102700
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number25MA06102700
License Number StateNJ

VIII. Authorized Official

Name: DR. GIOVANNI BATISTA RAMUNDO
Title or Position: OWNER
Credential: M.D.
Phone: 973-467-1466