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General NPI Number Information
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NPI Number | 1528164258
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Entity Type | Organization
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Legal Business Name | HIGHLANDS INTERVENTIONAL PAIN MANAGEMENT LLC
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Dates
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Enumeration Date | 09/16/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 123 NEWTON SPARTA RD
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City | NEWTON
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State | NJ
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Zip | 07860-2769
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Country | US
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Telephone | 973-729-8228
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Fax | 973-729-8249
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Provider Business Mailing Address
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Address Line | PO BOX 1227
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City | SPARTA
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State | NJ
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Zip | 07871-5227
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Country | US
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Telephone | 973-729-8228
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Fax | 973-729-8249
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Authorized Official
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Title or Position | PRESIDENT
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Name | ROSS NOCHIMSON
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Credential | D.O.
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Telephone | 973-729-8228
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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 | 25MB06803700
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License Number State | NJ
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