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is a Pain Medicine - Interventional Pain Medicine based in Newark, New Jersey. is licensed to practice in * (Not Available) (license number ) and their current practice location is 1060 Broad St, Newark, New Jersey. It can be reached at their office (for appointments etc.) via phone at (856) 577-1435.

NPI number for is 1275167967 and their current mailing address is 200 Walt Whitman Ave Unit 1268, Mount Laurel, New Jersey. does not participate in medicare program and thus does not accept medicare assignments. The facility's NPI Number is 1275167967.

Contact Information

1060 Broad St,
Newark, NJ 07102-2397
(856) 577-1435
(856) 780-6219

Map and Direction




Healthcare Provider's Profile

Full Name
TypeFacility
SpecialityPain Medicine - Interventional Pain Medicine
Location1060 Broad St, Newark, New Jersey
Accepts Medicare AssignmentsDoes not participate in Medicare Program. The facility may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1275167967
  • Provider Enumeration Date: 03/03/2020
  • Last Update Date: 08/10/2021

Medical Identifiers

Medical identifiers for such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1275167967NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
111N00000XChiropractor (* (Not Available))Secondary
171100000XAcupuncturist (* (Not Available))Secondary
207L00000XAnesthesiology (* (Not Available))Secondary
207LP2900XAnesthesiology - Pain Medicine (* (Not Available))Secondary
2086S0129XSurgery - Vascular Surgery (* (Not Available))Secondary
208VP0000XPain Medicine - Pain Medicine (* (Not Available))Secondary
208VP0014XPain Medicine - Interventional Pain Medicine (* (Not Available))Primary
225100000XPhysical Therapist (* (Not Available))Secondary
225200000XPhysical Therapy Assistant (* (Not Available))Secondary
225700000XMassage Therapist (* (Not Available))Secondary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address

200 Walt Whitman Ave Unit 1268,
Mount Laurel, NJ 08054-8060

Ph: (856) 577-1435
1060 Broad St,
Newark, NJ 07102-2397

Ph: (856) 577-1435

Reviews and Comments



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Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.