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General NPI Number Information
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NPI Number | 1437332558
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Entity Type | Organization
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Legal Business Name | PAIN SPINE & REHAB
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Dates
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Enumeration Date | 12/12/2007
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Last Update Date | 12/12/2007
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Provider Practice Location Address
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Address Line | 6 VILLAGE SQ E 2ND FLOOR
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City | CLIFTON
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State | NJ
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Zip | 07011-1555
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Country | US
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Telephone | 201-936-4730
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 24008
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City | JERSEY CITY
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State | NJ
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Zip | 07304-0701
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Country | US
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Telephone | 201-936-4730
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. MARIAM S RUBBANI
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Credential | M.D.
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Telephone | 201-936-4730
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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