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General NPI Number Information
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NPI Number | 1316133481
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Entity Type | Organization
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Legal Business Name | PAINCARE & REHAB CENTER
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Dates
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Enumeration Date | 09/21/2007
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Last Update Date | 09/21/2007
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Provider Practice Location Address
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Address Line | 15 JAMES ST SUITE 2
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City | FLORHAM PARK
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State | NJ
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Zip | 07932-1346
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Country | US
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Telephone | 973-822-3338
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Fax | 973-822-8098
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Provider Business Mailing Address
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Address Line | 15 JAMES ST SUITE 2
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City | FLORHAM PARK
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State | NJ
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Zip | 07932-1346
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Country | US
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Telephone | 973-822-3338
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Fax | 973-822-8098
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MIMI A. CHANG
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Credential | M.D.
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Telephone | 973-822-3338
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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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 | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State |
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