Paindoctors Medical LLC

Primary specialty

Pain Medicine PhysicianTaxonomy code 208VP0000X

Legal business name

PAINDOCTORS MEDICAL LLC

Practice address

814 Undercliff Ave
Edgewater, NJ 07020-1521

Phone

(908) 906-7813

NPI assigned

Mar 15, 2023

Organization subpart

No

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

Authorized official

Name

Ilana Etelzon

Title

Owner

Phone

(908) 906-7813

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1678838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686096000000",
    "number": "1679274658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 209",
            "city": "EDGEWATER",
            "state": "NJ",
            "postal_code": "070200209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "814 UNDERCLIFF AVE",
            "city": "EDGEWATER",
            "state": "NJ",
            "postal_code": "070201521",
            "telephone_number": "908-906-7813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAINDOCTORS MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-15",
        "last_updated": "2023-06-07",
        "certification_date": "2023-06-07",
        "status": "A",
        "authorized_official_last_name": "ETELZON",
        "authorized_official_first_name": "ILANA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "908-906-7813"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2023; 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.