Provider Demographics
NPI:1447370085
Name:NORTH JERSEY PAIN MANAGEMENT CENTER
Entity type:Organization
Organization Name:NORTH JERSEY PAIN MANAGEMENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:MAREE
Authorized Official - Middle Name:K
Authorized Official - Last Name:CASATELLI
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:973-383-0173
Mailing Address - Street 1:39 NEWTON SPARTA RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:NEWTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07860-2773
Mailing Address - Country:US
Mailing Address - Phone:973-383-0173
Mailing Address - Fax:973-383-6907
Practice Address - Street 1:39 NEWTON SPARTA RD
Practice Address - Street 2:SUITE B
Practice Address - City:NEWTON
Practice Address - State:NJ
Practice Address - Zip Code:07860-2773
Practice Address - Country:US
Practice Address - Phone:973-383-0173
Practice Address - Fax:973-383-6907
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ034570Medicare ID - Type Unspecified