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General NPI Number Information
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NPI Number | 1407462815
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Entity Type | Organization
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Legal Business Name | OPTIMAL PAIN & SPINE
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Dates
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Enumeration Date | 09/21/2020
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Last Update Date | 09/21/2020
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Provider Practice Location Address
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Address Line | 757 ROUTE 202/206 STE 104
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City | BRIDGEWATER
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State | NJ
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Zip | 08807-1763
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Country | US
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Telephone | 973-570-3849
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Fax |
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Provider Business Mailing Address
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Address Line | 35 PEBBLE BEACH DR
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City | LIVINGSTON
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State | NJ
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Zip | 07039-8208
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Country | US
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Telephone | 973-570-3849
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Fax |
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Authorized Official
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Title or Position | FOUNDER
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Name | DANIEL ROTHSTEIN
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Credential | MD
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Telephone | 973-570-3849
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number |
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License Number State |
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