NJ Spine&Pain Institute

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

License

25MA077775000 Issued in NJ

Legal business name

NJ SPINE&PAIN INSTITUTE

Practice address

59 Main St
Suite 353
West Orange, NJ 07052-5341

Phone

(908) 399-9835

NPI assigned

Oct 2, 2013

Last updated

Oct 2, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Joseph Ibrahim, MD

Title

MD/Owner

Phone

(908) 399-9835

Specialties & licenses 1

Addresses

Tax ID family

NJ Spine and Pain Institute LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• NJ Spine and Pain Institute LLC

  • Pain Medicine Physician
  • Bayonne, NJ
  • NPI 1841632973
  NPD tax ID

Locations

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

{
    "created_epoch": "1380672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380672000000",
    "number": "1639506892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59 MAIN ST",
            "address_2": "SUITE 353",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070525341",
            "telephone_number": "908-399-9835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59 MAIN ST",
            "address_2": "SUITE 353",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070525341",
            "telephone_number": "908-399-9835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NJ SPINE&PAIN INSTITUTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-02",
        "last_updated": "2013-10-02",
        "status": "A",
        "authorized_official_last_name": "IBRAHIM",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "MD/OWNER",
        "authorized_official_telephone_number": "908-399-9835",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NJ",
            "license": "25MA077775000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shaine Easo Ninan, PHARM D, RPH
• NJ Allergy MD, LLC
• NJ Endovascular & Amputation Prevention LLC
• NJ Multi-Disciplinary Medical Associates LLC
• NJ Spine and Brain Surgery
• NJ Vein & Cosmetic Surgery Center, PA
• Njmedix Ambulatory Transportation Corporation
• Nadine P Noel, APN-FNP-BC
• North Jersey Gastroenterology Associates, P.a.
• Northern New Jersey Anesthesiology

• Interventional Pain Medicine Physician in West Orange, NJ
• Providers in West Orange, NJ by specialty
• Interventional Pain Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2013; 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.