Healthcare Provider Details

I. General information

NPI: 1366752735
Provider Name (Legal Business Name): NJA- BETH ACUTE PAIN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2010
Last Update Date: 10/19/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 LYONS AVE
NEWARK NJ
07112
US

IV. Provider business mailing address

25B VREELAND ROAD SUITE 110
FLORHAM PARK NJ
07932
US

V. Phone/Fax

Practice location:
  • Phone: 973-660-9334
  • Fax: 973-660-9779
Mailing address:
  • Phone: 973-660-9334
  • Fax: 973-660-9779

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: PEDRO CABRERA-BONET
Title or Position: DIRECTOR/MANAGING OFFICER
Credential: MD
Phone: 973-660-9334