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General NPI Number Information
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NPI Number | 1598700999
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Entity Type | Organization
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Legal Business Name | INTERVENTIONAL SPINE AND PAIN TREATMENT CENTER, PC
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Dates
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Enumeration Date | 06/19/2006
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Last Update Date | 09/17/2010
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Provider Practice Location Address
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Address Line | 535 HIGH MOUNTAIN RD SUITE 202
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City | NORTH HALEDON
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State | NJ
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Zip | 07508-2665
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Country | US
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Telephone | 973-949-5009
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Fax | 973-949-5010
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Provider Business Mailing Address
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Address Line | PO BOX 604
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City | SADDLE RIVER
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State | NJ
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Zip | 07458-0604
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Country | US
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Telephone | 973-949-5009
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Fax | 973-949-5010
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Authorized Official
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Title or Position | OWNER
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Name | TERRY RAMNANAN
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Credential | MD
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Telephone | 973-949-5009
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 25MA04543000
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | 25MA04543000
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License Number State | NJ
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