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General NPI Number Information
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NPI Number | 1982902268
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Entity Type | Organization
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Legal Business Name | TWIN RIVERS PAIN MANAGEMENT PC
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Dates
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Enumeration Date | 03/10/2011
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Last Update Date | 07/23/2012
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Provider Practice Location Address
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Address Line | 755 MEMORIAL PKWY SUITE 202A
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City | PHILLIPSBURG
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State | NJ
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Zip | 08865-2748
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Country | US
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Telephone | 908-454-5338
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Fax | 908-454-0338
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Provider Business Mailing Address
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Address Line | 755 MEMORIAL PKWY SUITE 202A
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City | PHILLIPSBURG
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State | NJ
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Zip | 08865-2748
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Country | US
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Telephone | 908-454-5338
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Fax | 908-454-0338
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MR. ARUN M KANDRA
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Credential | MD
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Telephone | 973-777-5444
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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 | 25MA08387400
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License Number State | NJ
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