Organization Active NPI

Ta Pain and Wellness LLC

  • Interventional Pain Medicine Physician
  • Ridgewood, NJ
National Provider Identifier
1508795006
Registry record updated Jul 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
Legal business name
TA PAIN AND WELLNESS LLC
Practice address
143 E Ridgewood Ave
Ridgewood, NJ 07450-3815
Phone
(551) 222-0048
NPI assigned
May 19, 2026
Last updated
Jul 22, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2026

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

Authorized official

Name
Andrea Vasquez
Title
Manager
Phone
(551) 222-0048

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0014X Primary

Addresses

Primary practice location

143 E Ridgewood Ave
Ridgewood, NJ 07450-3815

Mailing address

143 E Ridgewood Ave Ste 1147
Ridgewood, NJ 07450-3815
Phone (551) 222-0048

National Provider Directory

National Provider Directory

Locations

143 E Ridgewood Ave
Ridgewood, NJ 07450
Phone (201) 588-3801

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1779148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784678400000",
    "number": "1508795006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "143 E RIDGEWOOD AVE STE 1147",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074503815",
            "telephone_number": "551-222-0048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "143 E RIDGEWOOD AVE",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074503815",
            "telephone_number": "551-222-0048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TA PAIN AND WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-05-19",
        "last_updated": "2026-07-22",
        "certification_date": "2026-07-22",
        "status": "A",
        "authorized_official_last_name": "VASQUEZ",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "551-222-0048"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2026; 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.