| Organization Name: | PAIN CENTER NJ PC |
| NPI Number: | 1124442124 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ASMA SIDDIQUI (OWNER) |
| Mailing Address: | 4359 Highway 516 Matawan |
| State: | NJ US |
| Postal Code: | 077472158 |
| Phone Number: | 7326367888 |
| Fax Number: | 7326367887 |
| NPI Enumeration Date: | 02/11/2014 |
| NPI Last Update Date: | 02/27/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP3300X |
| License Number: | 25MA07807000 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Pain |
| Taxonomy Definition: | |