| Organization Name: | INNOVATIVE PAIN MANAGEMENT, LLC |
| NPI Number: | 1215246459 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | GARY L YEN (OWNER) |
| Mailing Address: | 199 Main St 2nd Fl Keansburg |
| State: | NJ US |
| Postal Code: | 077341734 |
| Phone Number: | 7324950777 |
| Fax Number: | 7324951009 |
| NPI Enumeration Date: | 10/06/2010 |
| NPI Last Update Date: | 03/08/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2081P2900X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Physical Medicine & Rehabilitation |
| Taxonomy Specialization: | Pain Medicine |
| Taxonomy Definition: | A physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists. |