| Organization Name: | ADVANCED INTERVENTIONAL PAIN MANAGEMENT CENTER, LLC |
| NPI Number: | 1205227030 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KETA PATEL (PRACTICE MANAGER) |
| Mailing Address: | 26 Throckmorton Ln Second Floor Old Bridge |
| State: | NJ US |
| Postal Code: | 088572520 |
| Phone Number: | 7329525533 |
| Fax Number: | 7327074732 |
| NPI Enumeration Date: | 02/16/2015 |
| NPI Last Update Date: | 02/16/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP3300X |
| License Number: | 25MP00356700 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Pain |
| Taxonomy Definition: | |