Organization Active NPI

Pain and Spine Treatment Centers PC

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Burlington, NJ
National Provider Identifier
1053515023
Registry record updated Oct 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
License
25MB04709600 Issued in NJ
Legal business name
PAIN AND SPINE TREATMENT CENTERS PC
Practice address
811 Sunset Rd
Burlington, NJ 08016
Phone
(610) 237-5006
Fax
(610) 237-4138
NPI assigned
Jun 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Gerald E. Dworkin, D.O.
Title
President
Phone
(610) 237-5006

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2081P2900X 25MB04709600 NJ Primary

Addresses

Primary practice location

811 Sunset Rd
Burlington, NJ 08016

Mailing address

1503 Lansdowne Ave
Ste 2001
Darby, PA 19023
Phone (610) 237-5006

Other identifiers 2

IdentifierTypeStateIssuer
2182408MedicaidNJ
114936W05OtherNJPTAN

National Provider Directory

National Provider Directory

Locations

950 S Chester Ave
Rear
Delran, NJ 08075

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412294400000",
    "number": "1053515023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1503 LANSDOWNE AVE",
            "address_2": "STE 2001",
            "city": "DARBY",
            "state": "PA",
            "postal_code": "19023",
            "telephone_number": "610-237-5006",
            "fax_number": "610-237-4138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 SUNSET RD",
            "city": "BURLINGTON",
            "state": "NJ",
            "postal_code": "08016",
            "telephone_number": "610-237-5006",
            "fax_number": "610-237-4138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIN AND SPINE TREATMENT CENTERS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-13",
        "last_updated": "2014-10-03",
        "status": "A",
        "authorized_official_last_name": "DWORKIN",
        "authorized_official_first_name": "GERALD",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "610-237-5006",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "NJ",
            "license": "25MB04709600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2182408",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "114936W05",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.