MEDICARE: PREMIER BRAIN AND SPINE LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	363L00000X	Nurse Practitioner
2	207P00000X	Emergency Medicine Physician
3	332B00000X	Durable Medical Equipment & Medical Supplies
4	363A00000X	Physician Assistant
5	261QU0200X	Urgent Care Clinic/Center

General Provider Information

NPI Number	:	1386529717
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PREMIER BRAIN AND SPINE LLC

Provider Business Mailing Address
First Line	:	90 MATAWAN RD STE 302
Second Line	:
City	:	MATAWAN
State	:	NJ
Zip	:	07747-2653
Country	:	US
Telephone Number	:	732-441-7177
Fax Number	:	732-441-7165

Provider Business Practice Location Address
First Line	:	100 CAMPUS TOWN CIR STE 100
Second Line	:
City	:	EWING
State	:	NJ
Zip	:	08638-1962
Country	:	US
Telephone Number	:	609-799-7009
Fax Number	:	609-799-7808

Authorized Official
Title or Position	:	PART-OWNER: MANAGING MEMBER
Name	:	DR. ERIC D FREEMAN
Credential	:	DO
Telephone Number	:	732-906-9600

Provider Enumeration Date	:	08/06/2025
Last Update Date	:	11/12/2025

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