Prime Pain Clinic P.C.

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

PRIME PAIN CLINIC P.C.

Practice address

118 Broad Ave
Ste N10
Palisades Park, NJ 07650

Phone

(201) 313-1122

Fax

(201) 941-1157

NPI assigned

Apr 16, 2014

Organization subpart

No

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

Authorized official

Name

Mr. Tae Sik Ra, RPT

Title

Owner

Phone

(201) 313-1122

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1397606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482364800000",
    "number": "1437579505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 BROAD AVE SUITE N10",
            "city": "PALISADES PARK",
            "state": "NJ",
            "postal_code": "07650",
            "telephone_number": "201-313-1122",
            "fax_number": "201-941-1157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 BROAD AVE",
            "address_2": "STE N10",
            "city": "PALISADES PARK",
            "state": "NJ",
            "postal_code": "07650",
            "telephone_number": "201-313-1122",
            "fax_number": "201-941-1157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME PAIN CLINIC P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-16",
        "last_updated": "2016-12-22",
        "status": "A",
        "authorized_official_last_name": "RA",
        "authorized_official_first_name": "TAE SIK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "201-313-1122",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Prime Painmanagement PC
• Prime Spinecare
• Prime Total Pain Clinic PC
• Resam Healing US Inc
• Reset Acupuncture LLC

• Physical Therapist in Palisades Park, NJ
• Providers in Palisades Park, NJ by specialty
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 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.