Desio Pain Institute P.a.

Primary specialty

Pain Medicine PhysicianTaxonomy code 208VP0000X

License

25MA06205300 Issued in NJ

Legal business name

DESIO PAIN INSTITUTE P.A.

Practice address

452 Lakehurst Rd
Toms River, NJ 08755-6344

Phone

(732) 349-1053

Fax

(732) 349-9092

NPI assigned

Jan 10, 2012

Organization subpart

No

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

Authorized official

Name

Joann Tiedemann

Title

Billing Agent

Phone

(732) 257-5454

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1326153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326844800000",
    "number": "1295005122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1110",
            "city": "WALL",
            "state": "NJ",
            "postal_code": "077191110",
            "telephone_number": "732-349-1053",
            "fax_number": "732-349-9092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "452 LAKEHURST RD",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087556344",
            "telephone_number": "732-349-1053",
            "fax_number": "732-349-9092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESIO PAIN INSTITUTE P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-10",
        "last_updated": "2012-01-18",
        "status": "A",
        "authorized_official_last_name": "TIEDEMANN",
        "authorized_official_first_name": "JOANN",
        "authorized_official_title_or_position": "BILLING AGENT",
        "authorized_official_telephone_number": "732-257-5454"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "NJ",
            "license": "25MA06205300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mariia Derosa
• Celeste Derose
• Kristina Derrick, MD
• Akhilesh S Desai, MD
• Dilip N Desai, M.D. PA
• Laurence R Desrochers, MD
• Vincent F Destasio, DO
• Robert K Destefano, ATC
• Kimberlee Devaney
• Paige Devecka, PMHNP BC

• Pain Medicine Physician in Toms River, NJ
• Providers in Toms River, NJ by specialty
• 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.