Healthcare Provider Details

I. General information

NPI: 1467324103
Provider Name (Legal Business Name): NEWARK PAIN & INJURY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2025
Last Update Date: 09/22/2025
Certification Date: 09/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

332 FERRY ST
NEWARK NJ
07105-3548
US

IV. Provider business mailing address

332 FERRY ST
NEWARK NJ
07105-3548
US

V. Phone/Fax

Practice location:
  • Phone: 973-512-2100
  • Fax: 973-512-2150
Mailing address:
  • Phone: 973-512-2100
  • Fax: 973-512-2150

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: JORGE DE LA TORRE JR.
Title or Position: OWNER
Credential: DC
Phone: 973-512-2100