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General NPI Number Information
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NPI Number | 1942659123
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Entity Type | Organization
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Legal Business Name | STRATEGIC PAIN MANAGEMENT LLC
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Dates
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Enumeration Date | 06/08/2016
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Last Update Date | 06/08/2016
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Provider Practice Location Address
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Address Line | 50 MOUNT PROSPECT AVE SUITE 209
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City | CLIFTON
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State | NJ
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Zip | 07013-1900
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Country | US
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Telephone | 973-779-7361
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Fax |
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Provider Business Mailing Address
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Address Line | 50 MOUNT PROSPECT AVE SUITE 209
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City | CLIFTON
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State | NJ
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Zip | 07013-1900
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Country | US
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Telephone | 973-779-7361
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Fax |
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Authorized Official
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Title or Position | SOLE MBR
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Name | DR. ANJALI PATEL
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Credential | DO
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Telephone | 973-779-7361
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | 25MB08416900
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License Number State | NJ
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