NEW JERSEY SPINE AND PAIN INSTITUTE LLC NPI 1972630788

NPI Information

NPI: 1972630788
Provider Name: NEW JERSEY SPINE AND PAIN INSTITUTE LLC
Classification: Clinic/Center - 261QP3300X
Entity Type: Organization

Specialization: Pain

CLIA Number: 31D2142239

Address:
19 E 27TH ST
BAYONNE, NJ
ZIP 07002
Phone: (201) 436-0033
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NEW JERSEY SPINE AND PAIN INSTITUTE LLC is a pain clinic center in Bayonne, NJ. NEW JERSEY SPINE AND PAIN INSTITUTE LLC NPI is 1972630788. The provider is registered as an organization entity type.

The provider's business location address is:

19 E 27TH ST
BAYONNE, NJ
ZIP 07002-608
Phone: (201) 436-0033
Fax: (201) 436-0079

The provider's authorized official is Joseph G. A. Ibrahim .
The authorized official title is President and has the following contact phone number (201) 436-0033.

The CLIA number assigned to this NPI record is 31D2142239 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/28/2007 and was last updated on 8/21/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP3300X	Clinic/Center	Pain	25MA07777500	NEW JERSEY	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	109180	MEDICARE PIN	NEW JERSEY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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