Organization Active NPI

Professional Diagnostic Specialists,

  • Interventional Pain Medicine Physician
  • Manalapan, NJ
National Provider Identifier
1174825343
Registry record updated Dec 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
Legal business name
PROFESSIONAL DIAGNOSTIC SPECIALISTS,
Practice address
345 US Highway 9
Suite 8
Manalapan, NJ 07726-3239
Phone
(732) 845-2200
Fax
(732) 837-4514
NPI assigned
Nov 22, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2011

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

Authorized official

Name
Dr. Igor Priven, M.D.
Title
Medical Director
Phone
(718) 896-6443

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0014X Primary

Addresses

Primary practice location

345 US Highway 9
Suite 8
Manalapan, NJ 07726-3239

Mailing address

4 Winterberry CT
Marlboro, NJ 07746
Phone (718) 986-6443

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1290384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1324425600000",
    "number": "1174825343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 WINTERBERRY CT",
            "city": "MARLBORO",
            "state": "NJ",
            "postal_code": "07746",
            "telephone_number": "718-986-6443",
            "fax_number": "732-837-4514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 US HIGHWAY 9",
            "address_2": "SUITE 8",
            "city": "MANALAPAN",
            "state": "NJ",
            "postal_code": "077263239",
            "telephone_number": "732-845-2200",
            "fax_number": "732-837-4514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL DIAGNOSTIC SPECIALISTS,",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-22",
        "last_updated": "2011-12-21",
        "status": "A",
        "authorized_official_last_name": "PRIVEN",
        "authorized_official_first_name": "IGOR",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "718-896-6443",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manalapan, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2011; 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.