Advanced Spine and Pain, LLC
Organization Active NPI Interventional Pain Medicine Physician · Cherry Hill, NJ
NPI 1407002124 · NPPES record last updated Feb 6, 2023
Key facts
- NPI
- 1407002124
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Interventional Pain Medicine Physician 208VP0014X
- Legal business name
- ADVANCED SPINE AND PAIN, LLC
- Practice address
- 1400 Route 70 E
Cherry Hill, NJ 08034-2240 - Phone
- (888) 985-2727
- Fax
- (856) 779-0211
- NPI assigned
- Aug 13, 2008
- Organization subpart
- No
Authorized official
- Name
- Damean William Freas
- Title
- Ceo
- Phone
- (888) 985-2727
Other NPIs on the same Medicare enrollment 2
Other NPIs with the same Medicare PAC ID 10
Practitioners 44
-
Mary-Margaret Epifano, M.S. CCC-SLP
-
Young J. Lee, M.D.
-
Devin Oakes, D.O.
-
Jacklyn Sarah Rendfrey, M.S. CCC-SLP
-
Robert Todd Rinnier, D.O.
-
William R. Wolfe, M.D.
-
Addison Haskins, CRNP
-
Kishor K Patil, MD
-
Russell I Abrams, M.D.
-
Cynthia L Boyer, PH.D.
-
Kerri Anne Buscaglia, PA-C
-
Maxwell Castor, P.A.C.
-
Chioma A Ezeadichie, D.O
-
Rachael Erica Felsenfeld, PSYD
-
Amy Marie Fletcher, BSN, RN, MSN, FNP-C
-
Barry Coleman Greenfield, RPA-C
-
Erin E Intessimoni, FNP-BC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in NJ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080423000019 | NJ | Part B Supplier - Clinic/Group Practice | 0648358234 |
Receives reassigned benefits from 45 practitioners 2 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Mount Laurel, NJ; Mullica Hill, NJ; Neptune, NJ; North Brunswick, NJ; Old Bridge, NJ; Pennsauken, NJ; Salem, NJ; Sewell, NJ… |
| O20110317000161 | NJ | DME Supplier - Physician - Interventional Pain Management | 0648358234 | Practice locations: Cherry Hill, NJ |
National Provider Directory
Locations
2301 E Evesham Rd
Ste 113
Voorhees, NJ 08043
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pain Medicine (Physical Medicine & Rehabilitation) Physician |
2081P2900X | NJ | ||
| Neurology Physician |
2084N0400X | NJ | ||
| Interventional Pain Medicine Physician |
208VP0014X | |||
| Interventional Pain Medicine Physician |
208VP0014X | NJ | Yes |
Addresses
Primary practice location
1400 Route 70 E
Cherry Hill, NJ 08034-2240
Mailing address
201 Defense Hwy Ste 205
Annapolis, MD 21401-7096
Phone (888) 985-2727
Other names
- Relievers
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- Advanced Rehabilitation System LLC
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All providers in Cherry Hill, NJ · Interventional Pain Medicine Physician in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 6, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.