Provider Demographics
NPI:1124324009
Name:NJ PAIN CENTER PC
Entity type:Organization
Organization Name:NJ PAIN CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HYUNIK
Authorized Official - Middle Name:
Authorized Official - Last Name:HWANGBO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:201-941-0990
Mailing Address - Street 1:21 GRAND AVE STE 503
Mailing Address - Street 2:
Mailing Address - City:PALISADES PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07650-1083
Mailing Address - Country:US
Mailing Address - Phone:201-941-0990
Mailing Address - Fax:201-941-0991
Practice Address - Street 1:21 GRAND AVE STE 503
Practice Address - Street 2:
Practice Address - City:PALISADES PARK
Practice Address - State:NJ
Practice Address - Zip Code:07650-1083
Practice Address - Country:US
Practice Address - Phone:201-941-0990
Practice Address - Fax:201-941-0991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-09
Last Update Date:2011-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00674700111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1568616845OtherNPI