Healthcare Provider Details

I. General information

NPI: 1851753008
Provider Name (Legal Business Name): BCT PAIN MANAGEMENT.LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2016
Last Update Date: 11/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

285 DURHAM AVE A2
SOUTH PLAINFIELD NJ
07080-2546
US

IV. Provider business mailing address

285 DURHAM AVE A2
SOUTH PLAINFIELD NJ
07080-2546
US

V. Phone/Fax

Practice location:
  • Phone: 732-718-3165
  • Fax:
Mailing address:
  • Phone: 732-718-3165
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number25MD00293500
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number25MA08559100
License Number StateNJ

VIII. Authorized Official

Name: DR. BAO CHAU M TRAN
Title or Position: CO-OWNER
Credential: M.D.
Phone: 732-718-3165