NPIMap

Organization Active NPI

New Jersey Pain Center PC

  • Chiropractor
  • Ridgefield, NJ
National Provider Identifier
1699227686
Registry record updated Oct 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
38MC0052330 Issued in NJ
Legal business name
NEW JERSEY PAIN CENTER PC
Practice address
845 Broad Ave
102
Ridgefield, NJ 07657-1002
Phone
(201) 575-2783
NPI assigned
Oct 26, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2018

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

Authorized official

Name
Insun S Park, DC
Title
Owner
Phone
(201) 575-2783

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 38MC0052330 NJ Primary

Addresses

Primary practice location

845 Broad Ave
102
Ridgefield, NJ 07657-1002

Mailing address

100 Winston Dr Apt 6BN
Cliffside Park, NJ 07010-3264
Phone (201) 575-2783

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1477440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1539302400000",
    "number": "1699227686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 WINSTON DR APT 6BN",
            "city": "CLIFFSIDE PARK",
            "state": "NJ",
            "postal_code": "070103264",
            "telephone_number": "201-575-2783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "845 BROAD AVE",
            "address_2": "102",
            "city": "RIDGEFIELD",
            "state": "NJ",
            "postal_code": "076571002",
            "telephone_number": "201-575-2783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW JERSEY PAIN CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-26",
        "last_updated": "2018-10-12",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "INSUN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "201-575-2783",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC0052330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgefield, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 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.