Healthcare Provider Details

I. General information

NPI: 1942189956
Provider Name (Legal Business Name): PRECISION PAIN AND VASCULAR LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2025
Last Update Date: 09/15/2025
Certification Date: 09/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 DEAN DR LOWR LEVEL1N
TENAFLY NJ
07670-2765
US

IV. Provider business mailing address

2 DEAN DR LOWR LEVEL1N
TENAFLY NJ
07670-2765
US

V. Phone/Fax

Practice location:
  • Phone: 201-592-7246
  • Fax: 201-540-9978
Mailing address:
  • Phone: 201-592-7246
  • Fax: 201-540-9978

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: ERICA LOUGHLIN
Title or Position: ADMINISTRATOR
Credential:
Phone: 201-592-7246