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	208VP0014X	Interventional Pain Medicine Physician
2	2084P2900X	Pain Medicine (Psychiatry & Neurology) Physician
3	363L00000X	Nurse Practitioner
4	208100000X	Physical Medicine & Rehabilitation Physician
5	225100000X	Physical Therapist
6	207XS0117X	Orthopaedic Surgery of the Spine Physician
7	111N00000X	Chiropractor
8	207Q00000X	Family Medicine Physician
9	363AM0700X	Medical Physician Assistant
10	207X00000X	Orthopaedic Surgery Physician
11	207T00000X	Neurological Surgery Physician

General Provider Information

NPI Number	:	1922771377
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	:	2500 MORRIS AVE STE 220
Second Line	:
City	:	UNION
State	:	NJ
Zip	:	07083-5675
Country	:	US
Telephone Number	:	738-906-9600
Fax Number	:	732-377-0393

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

Provider Enumeration Date	:	07/30/2021
Last Update Date	:	02/26/2026

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Directions to “PREMIER BRAIN AND SPINE, LLC ” Practice Location

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