| Organization Name: | CENTER FOR PAIN CONTROL NEW BRUNSWICK, LLC |
| NPI Number: | 1376735811 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | GABRIELE PHILIP JASPER (MANAGING MEMBER) |
| Mailing Address: | 440 S Main St Milltown |
| State: | NJ US |
| Postal Code: | 088501725 |
| Phone Number: | 7329670050 |
| Fax Number: | |
| NPI Enumeration Date: | 08/17/2007 |
| NPI Last Update Date: | 11/15/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP3300X |
| License Number: | 25MA06352100 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Pain |
| Taxonomy Definition: | |