Provider Demographics
NPI:1194745448
Name:CENTER FOR ADVANCED PAIN MANAGEMENT AND REHABILITATION, LLC
Entity type:Organization
Organization Name:CENTER FOR ADVANCED PAIN MANAGEMENT AND REHABILITATION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BOQING
Authorized Official - Middle Name:
Authorized Official - Last Name:CHEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-516-1060
Mailing Address - Street 1:249 BRIDGE ST
Mailing Address - Street 2:BUILDING G
Mailing Address - City:METUCHEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08840-2294
Mailing Address - Country:US
Mailing Address - Phone:732-516-1060
Mailing Address - Fax:732-516-1015
Practice Address - Street 1:249 BRIDGE ST
Practice Address - Street 2:BUILDING G
Practice Address - City:METUCHEN
Practice Address - State:NJ
Practice Address - Zip Code:08840-2294
Practice Address - Country:US
Practice Address - Phone:732-516-1060
Practice Address - Fax:732-516-1015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA 066877174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJG65810Medicare UPIN
NJ070899Medicare ID - Type Unspecified