Advanced Spine & Sports Medicine Specialist LLC

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

License

MA066877 Issued in NJ

Legal business name

ADVANCED SPINE & SPORTS MEDICINE SPECIALIST LLC

Practice address

245 Bridge St BLDG G
Metuchen, NJ 08840-2294

Phone

(732) 902-6461

Fax

(732) 902-6463

NPI assigned

Jan 18, 2012

Last updated

Jan 18, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Boqing Chen

Title

Manager

Phone

(732) 902-6461

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1326844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326844800000",
    "number": "1275804650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 BRIDGE ST BLDG G",
            "city": "METUCHEN",
            "state": "NJ",
            "postal_code": "088402294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 BRIDGE ST BLDG G",
            "city": "METUCHEN",
            "state": "NJ",
            "postal_code": "088402294",
            "telephone_number": "732-902-6461",
            "fax_number": "732-902-6463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED SPINE & SPORTS MEDICINE SPECIALIST LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-18",
        "last_updated": "2012-01-18",
        "status": "A",
        "authorized_official_last_name": "CHEN",
        "authorized_official_first_name": "BOQING",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "732-902-6461"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NJ",
            "license": "MA066877",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NJ",
            "license": "MA066877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Interventional Pain Medicine Physician in Metuchen, NJ
• Providers in Metuchen, NJ by specialty
• Interventional Pain Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 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.