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General NPI Number Information
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NPI Number | 1871730846
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Entity Type | Organization
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Legal Business Name | ADVANCED PAIN MANAGEMENT AND SPINE HEALTH CENTER, LLC
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Dates
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Enumeration Date | 01/13/2009
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Last Update Date | 04/11/2014
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Provider Practice Location Address
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Address Line | 123 COLUMBIA TPKE UNIT 102B
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City | FLORHAM PARK
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State | NJ
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Zip | 07932-2117
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Country | US
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Telephone | 973-665-2011
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Fax |
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Provider Business Mailing Address
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Address Line | 8 KRISTEN CT
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City | SOMERSET
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State | NJ
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Zip | 08873-5048
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Country | US
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Telephone | 201-450-3090
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Fax |
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Authorized Official
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Title or Position | CEO, PRESIDENT, SOLE OWNER
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Name | DR. PRASHANT PATEL
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Credential | MD
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Telephone | 201-450-3090
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number | 25MA08057500
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License Number State | NJ
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