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General NPI Number Information
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NPI Number | 1841596533
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Entity Type | Organization
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Legal Business Name | ADVANCED PAIN THERAPY LLC
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Dates
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Enumeration Date | 01/28/2011
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Last Update Date | 07/07/2014
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Provider Practice Location Address
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Address Line | 1130 ROUTE 46 WEST SUITE 1
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City | PARSIPPANY
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State | NJ
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Zip | 07054
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Country | US
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Telephone | 973-294-6228
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Fax | 973-917-3174
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Provider Business Mailing Address
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Address Line | 1130 ROUTE 46 WEST SUITE 1
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City | PARSIPPANY
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State | NJ
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Zip | 07054
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Country | US
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Telephone | 973-294-6228
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Fax | 973-917-3174
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Authorized Official
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Title or Position | OWNER
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Name | MARCELLO SAMMARONE
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Credential | MD
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Telephone | 973-294-6228
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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 | 25MA05745200
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License Number State | NJ
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