NPIMap

Organization Active NPI

Tri-County Pain Management & Rehabilitation, PA

  • Anesthesiology Physician
  • Kearny, NJ
National Provider Identifier
1194760801
Registry record updated Jul 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
TRI-COUNTY PAIN MANAGEMENT & REHABILITATION, PA
Practice address
206 Bergen Ave
Kearny, NJ 07032-3324
Phone
(201) 955-7000
NPI assigned
Jun 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2007

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

Authorized official

Name
Philip Lutz, MDNPI 1275539645
Title
President
Phone
(208) 042-8008

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X Primary

Addresses

Primary practice location

206 Bergen Ave
Kearny, NJ 07032-3324

Mailing address

PO Box 43776
Upper Montclair, NJ 07043-0776
Phone (201) 804-2800

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184198400000",
    "number": "1194760801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 43776",
            "city": "UPPER MONTCLAIR",
            "state": "NJ",
            "postal_code": "070430776",
            "telephone_number": "201-804-2800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 BERGEN AVE",
            "city": "KEARNY",
            "state": "NJ",
            "postal_code": "070323324",
            "telephone_number": "201-955-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI-COUNTY PAIN MANAGEMENT & REHABILITATION, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-17",
        "last_updated": "2007-07-12",
        "status": "A",
        "authorized_official_last_name": "LUTZ",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-042-8008",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kearny, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2007; 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.