Coastal Back and Pain Institute

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

Legal business name

COASTAL BACK AND PAIN INSTITUTE

Practice address

459 Jack Martin Blvd
Brick, NJ 08724-7724

Phone

(732) 747-7077

NPI assigned

Jan 13, 2016

Organization subpart

No

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

Authorized official

Name

Douglas Manganelli, MD

Title

Owner

Phone

(732) 747-7077

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1452643200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452643200000",
    "number": "1407212905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 297",
            "city": "MANASQUAN",
            "state": "NJ",
            "postal_code": "087360297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "459 JACK MARTIN BLVD",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087247724",
            "telephone_number": "732-747-7077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL BACK AND PAIN INSTITUTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-13",
        "last_updated": "2016-01-13",
        "status": "A",
        "authorized_official_last_name": "MANGANELLI",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-747-7077",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Colleen Jayne Clayton, P.T.
• Tabitha Clifford, LSW
• Lucas Robert Cloppse, MD
• Scott R Cluley, MD
• Coast Physio LLC
• Coastal Cardiovascular Consultants, PA
• Coastal Counseling Center of Brick, LLC.
• Coastal Counseling Group
• Coastal Dermatology LLC
• Coastal Gastroenterology Associates, P.a.

• Pain Medicine (Anesthesiology) Physician in Brick, NJ
• Providers in Brick, NJ by specialty
• Pain Medicine (Anesthesiology) Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 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.