# TRI STATE SPINE AND PAIN PROFESSIONAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** TRI STATE SPINE AND PAIN PROFESSIONAL CORPORATION
- **Organization subpart:** No

## Provider details

- **NPI number:** 1144970419
- **Authorized official:** MIKHAIL ARTAMONOV MD (CEO)
- **Authorized official phone:** (570) 972-6778

## Contact information

- **Practice address:** 596 ANDERSON AVE STE 216, CLIFFSIDE PARK, NJ 07010-1856
- **Practice address phone:** (551) 277-2071
- **Practice address fax:** (561) 529-5144
- **Mailing address:** 596 ANDERSON AVE STE 216, CLIFFSIDE PARK, NJ 07010-1856
- **Mailing address phone:** (551) 277-2071
- **Mailing address fax:** (561) 529-5144

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | NULL | Yes |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/28/2022
- **Last updated:** 03/28/2022