New Jersey Spine & Pain Institute LLC

Primary specialty

Pain Clinic/CenterTaxonomy code 261QP3300X

License

25MA09983400 Issued in NJ

Legal business name

NEW JERSEY SPINE & PAIN INSTITUTE LLC

Practice address

19 E 27TH St
Bayonne, NJ 07002-4608

Phone

(201) 436-0033

Fax

(201) 436-0079

NPI assigned

Oct 26, 2016

Organization subpart

No

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

Authorized official

Name

Joseph Georgy Amin Azer Ibrahim, MD

Title

Medical Director

Phone

(201) 436-0033

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1477440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477440000000",
    "number": "1346792272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 E 27TH ST",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "070024608",
            "telephone_number": "201-436-0033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 E 27TH ST",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "070024608",
            "telephone_number": "201-436-0033",
            "fax_number": "201-436-0079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW JERSEY SPINE & PAIN INSTITUTE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-26",
        "last_updated": "2016-10-26",
        "status": "A",
        "authorized_official_last_name": "IBRAHIM",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "GEORGY AMIN AZER",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "201-436-0033",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": "NJ",
            "license": "25MA09983400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• New Jersey CVS Pharmacy LLC
• New Jersey CVS Pharmacy LLC
• New Jersey Imaging Associates, PC
• New Jersey Institute of Balance, LLC
• New Jersey Professional Medical Services LLC
• New Jersey Spine and Pain Institute LLC
• New Life Medical
• New Pathway Counseling Services
• Lindsey Hoang-VI Nguyen, DO
• Michael John Nicholson, DO

• Pain Clinic/Center in Bayonne, NJ
• Providers in Bayonne, NJ by specialty
• Pain Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2016; 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.