Provider Demographics
NPI:1871984724
Name:RIDGE PAIN MEDICINE & ANESTHESIOLOGY, LLC
Entity type:Organization
Organization Name:RIDGE PAIN MEDICINE & ANESTHESIOLOGY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO AND MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BINDER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-880-6161
Mailing Address - Street 1:140 N RTE 17
Mailing Address - Street 2:SUITE 204
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-2809
Mailing Address - Country:US
Mailing Address - Phone:201-880-6161
Mailing Address - Fax:201-880-6163
Practice Address - Street 1:25 LEACH AVE
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07656-1907
Practice Address - Country:US
Practice Address - Phone:201-391-2443
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-13
Last Update Date:2015-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08070400208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty