Active NPI
Pain Relief Center of America, Inc
- Pain Medicine (Anesthesiology) Physician
- West New York, NJ
National Provider Identifier
1780766493
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pain Medicine (Anesthesiology) Physician
- License
- 0400146384
- Legal business name
- PAIN RELIEF CENTER OF AMERICA, INC
- Practice address
- 211 60TH St
2ND Floor
West New York, NJ 07093-2805 - Phone
- (201) 869-3000
- Fax
- (201) 869-3001
- NPI assigned
- Oct 20, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jose Roque
- Title
- President
- Phone
- (201) 869-3000
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pain Medicine (Anesthesiology) Physician | 207LP2900X | 0400146384 | NJ | Primary |
Addresses
Primary practice location
211 60TH St
2ND Floor
West New York, NJ 07093-2805
Mailing address
211 60TH St
2ND Floor
West New York, NJ 07093-2805
Phone (201) 869-3000
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629188503 | Other | NPI | |
| 77331001 | Medicaid | NJ |
National Provider Directory
National Provider DirectoryLocations
211 60th St
#2
West New York, NJ 07093
Phone (201) 792-9081
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161302400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1780766493",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "211 60TH ST",
"address_2": "2ND FLOOR",
"city": "WEST NEW YORK",
"state": "NJ",
"postal_code": "070932805",
"telephone_number": "201-869-3000",
"fax_number": "201-869-3001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "211 60TH ST",
"address_2": "2ND FLOOR",
"city": "WEST NEW YORK",
"state": "NJ",
"postal_code": "070932805",
"telephone_number": "201-869-3000",
"fax_number": "201-869-3001"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PAIN RELIEF CENTER OF AMERICA, INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-10-20",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "ROQUE",
"authorized_official_first_name": "JOSE",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "201-869-3000"
},
"taxonomies": [
{
"code": "207LP2900X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Anesthesiology, Pain Medicine",
"state": "NJ",
"license": "0400146384",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI",
"identifier": "1629188503",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "77331001",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}
Other providers in West New York, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.