| Organization Name: | PAIN MANAGEMENT AND ANESTHESIOLOGY OF NJ PC |
| NPI Number: | 1043526957 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MIKHAIL SOLOMONOV (PRESIDENT) |
| Mailing Address: | 8 Saddle Rd Suite 204 Cedar Knolls |
| State: | NJ US |
| Postal Code: | 079271902 |
| Phone Number: | 9739987868 |
| Fax Number: | |
| NPI Enumeration Date: | 08/30/2010 |
| NPI Last Update Date: | 08/01/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP3300X |
| License Number: | 25MA07903700 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Pain |
| Taxonomy Definition: | |