MEDICARE: PAIN CONTROL ASSOCIATES PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208VP0000X	Pain Medicine Physician	25MA05475100	NJ
2	208VP0014X	Interventional Pain Medicine Physician	25MA05475100	NJ

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	7554260003	OTHER	NJ	MEDICARE NSC
2	7554260003	OTHER	NJ	MEDICARE DMEPOS

General Provider Information

NPI Number	:	1225589534
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PAIN CONTROL ASSOCIATES PC

Provider Business Mailing Address
First Line	:	2271 HIGHWAY 33 STE 103
Second Line	:
City	:	HAMILTON
State	:	NJ
Zip	:	08690-1749
Country	:	US
Telephone Number	:	609-890-4080
Fax Number	:	609-890-4090

Provider Business Practice Location Address
First Line	:	1201 NEW RD STE 120
Second Line	:
City	:	LINWOOD
State	:	NJ
Zip	:	08221-1152
Country	:	US
Telephone Number	:	888-407-5985
Fax Number	:	856-566-8666

Authorized Official
Title or Position	:	OWNER
Name	:	MARC P. PLOTNICK
Credential	:	MD
Telephone Number	:	609-890-4080

Provider Enumeration Date	:	10/21/2016
Last Update Date	:	07/21/2022

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Directions to “PAIN CONTROL ASSOCIATES PC ” Practice Location

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