NPIMap

Organization Active NPI

NJ Spine and Pain Institute LLC

  • Pain Medicine Physician
  • Bayonne, NJ
National Provider Identifier
1841632973
Registry record updated Jul 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
License
25MA07777500 Issued in NJ
Legal business name
NJ SPINE AND PAIN INSTITUTE LLC
Practice address
19 E 27TH St
Bayonne, NJ 07002-4608
Phone
(201) 436-0033
NPI assigned
Jul 17, 2013
Last updated
Jul 17, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2013

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

Authorized official

Name
Joseph G. Ibrahim, MDNPI 1225068281
Title
President
Phone
(973) 243-2010

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine Physician 208VP0000X 25MA07777500 NJ Primary

Addresses

Primary practice location

19 E 27TH St
Bayonne, NJ 07002-4608

Mailing address

19 E 27TH St
Bayonne, NJ 07002-4608
Phone (201) 436-0033

National Provider Directory

National Provider Directory
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.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1374019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374019200000",
    "number": "1841632973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 E 27TH ST",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "070024608",
            "telephone_number": "201-436-0033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 E 27TH ST",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "070024608",
            "telephone_number": "201-436-0033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NJ SPINE AND PAIN INSTITUTE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-17",
        "last_updated": "2013-07-17",
        "status": "A",
        "authorized_official_last_name": "IBRAHIM",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "973-243-2010",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "NJ",
            "license": "25MA07777500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayonne, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 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.