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General NPI Number Information
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NPI Number | 1366448979
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Entity Type | Organization
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Legal Business Name | NEW JERSEY PAIN CONSULTANTS PC
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Dates
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Enumeration Date | 06/28/2005
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Last Update Date | 03/23/2016
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Provider Practice Location Address
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Address Line | 310 MADISON AVE SUITE 301
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City | MORRISTOWN
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State | NJ
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Zip | 07960-6967
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Country | US
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Telephone | 973-998-9200
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 24004
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City | NEWARK
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State | NJ
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Zip | 07101-0406
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Country | US
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Telephone | 201-804-2800
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Fax | 201-804-8883
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Authorized Official
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Title or Position | PRESIDENT
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Name | MICHAEL E RUDMAN
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Credential | MD
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Telephone | 973-971-6824
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 | NJ
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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