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General NPI Number Information
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NPI Number | 1407214661
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Entity Type | Organization
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Legal Business Name | SPINE AND JOINT PAIN CENTER LLC
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Dates
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Enumeration Date | 02/03/2016
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Last Update Date | 02/03/2016
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Provider Practice Location Address
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Address Line | 399 NORTH AVE
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City | FANWOOD
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State | NJ
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Zip | 07023-1340
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Country | US
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Telephone | 908-247-9011
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Fax | 908-709-7301
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Provider Business Mailing Address
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Address Line | 399 NORTH AVE
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City | FANWOOD
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State | NJ
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Zip | 07023-1340
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Country | US
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Telephone | 908-247-9011
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Fax | 908-709-7301
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. ISMAIL A ALHAMRAWY
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Credential | M.D.
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Telephone | 908-247-9011
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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