# PAIN MEDICINE AND ANESTHESIA PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386925394
- **Authorized official:** DR. ROMAN KOSIBOROD D.O. (PRESIDENT)
- **Authorized official phone:** (201) 945-2900

## Contact information

- **Practice address:** 387 VANCE AVE, FRANKLIN LAKES, NJ 07417-3016
- **Practice address phone:** (201) 945-2900
- **Mailing address:** 387 VANCE AVE, FRANKLIN LAKES, NJ 07417-3016

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | 25MB07566200 | NJ | Yes |

## Other

- **Enumeration date:** 09/02/2011
- **Last updated:** 09/02/2011