=====================================================
General NPI Number Information
=====================================================
NPI Number | 1700842945
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | EDWARD S MAGAZINER MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/25/2006
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2186 ROUTE 27 SUITE 2D
-----------------------------------------------------
City | NORTH BRUNSWICK
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08902
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 732-297-2600
-----------------------------------------------------
Fax | 732-297-5770
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2186 ROUTE 27 SUITE 2D
-----------------------------------------------------
City | NORTH BRUNSWICK
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08902
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 732-297-2600
-----------------------------------------------------
Fax | 732-297-5770
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2081P2900X
-----------------------------------------------------
Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
-----------------------------------------------------
License Number | 25MA05340000
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------