Edison Spine & Pain Center LLC

Primary specialty

Pain Clinic/CenterTaxonomy code 261QP3300X

License

25MA08823500 Issued in NJ

Legal business name

EDISON SPINE & PAIN CENTER LLC

Practice address

940 Amboy Ave Ste 103
Edison, NJ 08837-2869

Phone

(347) 380-9138

NPI assigned

May 11, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Sukdeb Datta, MD, MBA

Title

President

Phone

(615) 479-4692

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1525996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525996800000",
    "number": "1780174136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "940 AMBOY AVE STE 103",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088372869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 AMBOY AVE STE 103",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088372869",
            "telephone_number": "347-380-9138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDISON SPINE & PAIN CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-11",
        "last_updated": "2018-05-11",
        "status": "A",
        "authorized_official_last_name": "DATTA",
        "authorized_official_first_name": "SUKDEB",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "615-479-4692",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD, MBA"
    },
    "taxonomies": [
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": "NJ",
            "license": "25MA08823500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edison Rehabilitation & Acupuncture,P.C
• Edison RX Inc
• Edison Sheltered Workshop, Inc.
• Edison Spinal Monitoring LLC
• Edison Spine & Joint Care LLC
• Edison Spine and Pain Management, P.C.
• Edison Spine Center
• Edison Surgery Center LLC
• Edison Surgical Center, L.L.C.
• Edison Township Board of Education

• Pain Clinic/Center in Edison, NJ
• Providers in Edison, NJ by specialty
• Pain Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 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.