NPIMap

Organization Active NPI

Pain Management and Wellness of Palisades

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Englewood, NJ
National Provider Identifier
1245593193
Registry record updated Jun 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
Legal business name
PAIN MANAGEMENT AND WELLNESS OF PALISADES
Practice address
350 Engle St
Ehmc Pain Management
Englewood, NJ 07631-1808
Phone
(201) 894-3595
Fax
(201) 894-9046
NPI assigned
Jun 15, 2012
Last updated
Jun 15, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2012

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

Authorized official

Name
Dr. Jeffrey Gudin, M.D.NPI 1831133420
Title
Director
Phone
(201) 569-7246

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
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2081P2900X Primary

Addresses

Primary practice location

350 Engle St
Ehmc Pain Management
Englewood, NJ 07631-1808

Mailing address

PO Box 9044
Bardonia, NY 10954-9044
Phone (201) 569-7246

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1339718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339718400000",
    "number": "1245593193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9044",
            "city": "BARDONIA",
            "state": "NY",
            "postal_code": "109549044",
            "telephone_number": "201-569-7246",
            "fax_number": "201-894-9046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 ENGLE ST",
            "address_2": "EHMC PAIN MANAGEMENT",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076311808",
            "telephone_number": "201-894-3595",
            "fax_number": "201-894-9046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIN MANAGEMENT AND WELLNESS OF PALISADES",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-15",
        "last_updated": "2012-06-15",
        "status": "A",
        "authorized_official_last_name": "GUDIN",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "201-569-7246",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2012; 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.