| Organization Name: | BERGEN NEUROLOGY AND PAIN MANAGEMENT PA |
| NPI Number: | 1841500881 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | VIJAYA R DASIKA (PRESIDENT) |
| Mailing Address: | 600 Pavonia Ave 3rd Floor Jersey City |
| State: | NJ US |
| Postal Code: | 073062929 |
| Phone Number: | 2014201522 |
| Fax Number: | 2014201633 |
| NPI Enumeration Date: | 10/08/2010 |
| NPI Last Update Date: | 11/11/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 204C00000X |
| License Number: | 25MA03289800 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Neuromusculoskeletal Medicine, Sports Medicine |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |