Healthcare Provider Details

I. General information

NPI: 1922161470
Provider Name (Legal Business Name): PAIN SPECIALISTS, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2006
Last Update Date: 09/07/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1907 NEW RD
NORTHFIELD NJ
08225-1544
US

IV. Provider business mailing address

1907 NEW RD
NORTHFIELD NJ
08225-1544
US

V. Phone/Fax

Practice location:
  • Phone: 609-645-8884
  • Fax: 609-645-9780
Mailing address:
  • Phone: 609-645-8884
  • Fax: 609-645-9780

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP3300X
TaxonomyPain Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. MORRIS ANTEBI
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 609-645-8884