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NPI 1114818713

NPI 1114818713 : PREMIER BRAIN AND SPINE LLC : HACKENSACK, NJ

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General NPI Number Information
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    NPI Number           |    1114818713
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    Entity Type          |    Organization 
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    Legal Business Name  |    PREMIER BRAIN AND SPINE LLC 
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Dates
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    Enumeration Date     |    07/11/2025
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    Last Update Date     |    07/29/2025
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Provider Practice Location Address
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    Address Line         |    2 UNIVERSITY PLZ STE 500 
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    City                 |    HACKENSACK
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    State                |    NJ
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    Zip                  |    07601-6228
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    Country              |    US
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    Telephone            |    551-340-8400
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    Fax                  |    551-340-8499
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Provider Business Mailing Address
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    Address Line         |    90 MATAWAN RD STE 302 
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    City                 |    MATAWAN
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    State                |    NJ
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    Zip                  |    07747-2653
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    Country              |    US
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    Telephone            |    732-441-7177
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    Fax                  |    732-441-7165
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Authorized Official
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    Title or Position    |    PART-OWNER: MANAGING MEMBER
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    Name                 |    DR. ERIC D FREEMAN 
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    Credential           |    DO
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    Telephone            |    732-906-9600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    207L00000X
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    Taxonomy Name        |    Anesthesiology Physician
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    207LP2900X
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    Taxonomy Name        |    Pain Medicine (Anesthesiology) Physician
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    License Number       |    
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    License Number State |    
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Taxonomy #3
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    Taxonomy Code        |    332B00000X
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    Taxonomy Name        |    Durable Medical Equipment & Medical Supplies
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    License Number       |    
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    License Number State |    
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