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NPI Code Detail

MEDICARE: NJ PAIN MED

MEDICARE: NJ PAIN MED
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
1207LP2900XPain Medicine (Anesthesiology) Physician
2208VP0014XInterventional Pain Medicine Physician

General Provider Information

NPI Number : 1255298188
Entity Type Code : Organization
Provider Name (Legal Business Name) : NJ PAIN MED
Provider Business Mailing Address
First Line : 20 MEADOWLANDS PKWY
Second Line :
City : SECAUCUS
State : NJ
Zip : 07094-2944
Country : US
Telephone Number : 201-381-4800
Fax Number :
Provider Business Practice Location Address
First Line : 20 MEADOWLANDS PKWY
Second Line :
City : SECAUCUS
State : NJ
Zip : 07094-2944
Country : US
Telephone Number : 201-381-4800
Fax Number :
Authorized Official
Title or Position : BILLING MANAGER
Name : HETAL RAO
Credential : RT
Telephone Number : 201-289-1790
Provider Enumeration Date : 01/05/2026
Last Update Date : 01/05/2026

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Directions to “NJ PAIN MED ” Practice Location

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