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General NPI Number Information
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NPI Number | 1366214207
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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 | 10/24/2023
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Last Update Date | 02/06/2025
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Provider Practice Location Address
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Address Line | 2271 HIGHWAY 33 STE 103
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City | HAMILTON
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State | NJ
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Zip | 08690-1749
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Country | US
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Telephone | 609-890-4080
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Fax | 609-890-4090
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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 MBR
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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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 | 207T00000X
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Taxonomy Name | Neurological Surgery 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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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Taxonomy #4
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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 #5
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #8
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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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