Provider Demographics
NPI:1174976609
Name:NEW JERSEY SPINE AND PAIN PHYSICIANS PC
Entity type:Organization
Organization Name:NEW JERSEY SPINE AND PAIN PHYSICIANS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SANJAY
Authorized Official - Middle Name:
Authorized Official - Last Name:BAKSHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-535-3505
Mailing Address - Street 1:PO BOX 714346
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45271-4346
Mailing Address - Country:US
Mailing Address - Phone:732-479-4421
Mailing Address - Fax:732-525-3570
Practice Address - Street 1:540 BORDENTOWN AVE
Practice Address - Street 2:
Practice Address - City:SOUTH AMBOY
Practice Address - State:NJ
Practice Address - Zip Code:08879-1546
Practice Address - Country:US
Practice Address - Phone:732-479-4421
Practice Address - Fax:732-525-3570
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-20
Last Update Date:2016-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty