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General NPI Number Information
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NPI Number | 1801062245
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Entity Type | Organization
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Legal Business Name | GARDEN STATE ANESTHESIA AND PAIN MANAGEMENT ASSOCIATES, LLC
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Dates
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Enumeration Date | 05/06/2008
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Last Update Date | 11/05/2008
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Provider Practice Location Address
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Address Line | 1692 OAK TREE RD SUITE 10
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City | EDISON
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State | NJ
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Zip | 08820-2853
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Country | US
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Telephone | 732-635-9729
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Fax | 732-906-7806
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Provider Business Mailing Address
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Address Line | 1692 OAK TREE RD SUITE 10
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City | EDISON
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State | NJ
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Zip | 08820-2853
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Country | US
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Telephone | 732-635-9729
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Fax | 732-906-7806
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. NATALIO DAMIEN JR.
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Credential | M.D.
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Telephone | 732-635-9729
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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 | 23182
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License Number State | NJ
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