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General NPI Number Information
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NPI Number | 1780989087
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Entity Type | Organization
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Legal Business Name | PAIN MANAGEMENT INSTITUTE PA
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Dates
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Enumeration Date | 01/18/2011
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Last Update Date | 03/04/2025
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Provider Practice Location Address
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Address Line | 619 RIVER DR
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City | ELMWOOD PARK
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State | NJ
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Zip | 07407-1317
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Country | US
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Telephone | 614-553-0964
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 986520 DEPT 160
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City | BOSTON
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State | MA
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Zip | 02298-6520
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Country | US
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Telephone | 207-784-2554
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Fax | 207-777-1439
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Authorized Official
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Title or Position | PRESIDENT
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Name | JAY TENDLER
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Credential | MD
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Telephone | 800-738-1659
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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