Bergen Pain Clinic LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

BERGEN PAIN CLINIC LLC

Practice address

333 Sylvan Ave Ste 326
Englewood Cliffs, NJ 07632-2724

Phone

(201) 408-5016

NPI assigned

Dec 10, 2018

Organization subpart

No

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

Authorized official

Name

Marievic Balaag Ebora Fernando, PT,DPT

Title

Manager

Phone

(201) 408-5016

Specialties & licenses 3

Addresses

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Youn Kang Oh, M.D.

  • Neurology Physician
  • Englewood Cliffs, NJ
  • NPI 1851458145
  NPD
• Jaehyun Park

  • Physical Therapist
  • North Bergen, NJ
  • NPI 1114706082
  NPD
• In Kuk Bang, LAC

  • Acupuncturist
  • Bayside, NY
  • NPI 1558890418
  NPD

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

{
    "created_epoch": "1544400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1544400000000",
    "number": "1497226971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 SYLVAN AVE STE 326",
            "city": "ENGLEWOOD CLIFFS",
            "state": "NJ",
            "postal_code": "076322724",
            "telephone_number": "201-408-5016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 SYLVAN AVE STE 326",
            "city": "ENGLEWOOD CLIFFS",
            "state": "NJ",
            "postal_code": "076322724",
            "telephone_number": "201-408-5016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERGEN PAIN CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-10",
        "last_updated": "2018-12-10",
        "status": "A",
        "authorized_official_last_name": "EBORA FERNANDO",
        "authorized_official_first_name": "MARIEVIC",
        "authorized_official_middle_name": "BALAAG",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "201-408-5016",
        "authorized_official_credential": "PT,DPT"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keith Richard Benoff, PH.D.
• Bergen Dermatology LLC
• Bergen Family Pediatrics, LLC
• Bergen JHP PT PC
• Bergen Pain & Rehab LLC
• Bergen Rehabilitation Services Inc.
• Bergen Wellness Center LLC
• Voltaire Vincent Bermudo, PT
• Bryson Christian Berry
• Miriam Besser, M.A., CCC-SLP

• Physical Therapy Clinic/Center in Englewood Cliffs, NJ
• Providers in Englewood Cliffs, NJ by specialty
• Physical Therapy Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2018; 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.