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General NPI Number Information
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NPI Number | 1326932906
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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 | 06/06/2025
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Last Update Date | 06/06/2025
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Provider Practice Location Address
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Address Line | 201 CREEK CROSSING BLVD
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City | HAINESPORT
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State | NJ
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Zip | 08036-2766
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Country | US
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Telephone | 609-261-5800
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Fax | 609-261-5801
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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 | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine 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 | 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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