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Organization
ATLANTIC PAIN AND PHYSICAL MEDICINE PC
Active
Organization
ATLANTIC PAIN AND PHYSICAL MEDICINE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRUCE M HAIRSTON M.D. (DOCTOR)
(609) 652-3933
Entity
Organization
Contact information
Practice address
236 E. JIMMIE LEEDS ROAD, SUITE A, GALLOWAY, NJ 08205-9599
(609) 652-3933
(609) 652-9409
Mailing address
PO BOX 306, POMONA, NJ 08240-0306
(609) 652-3933
(609) 652-9409
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
026341
NJ
208VP0000X
Pain Medicine Physician
25MA068015
NJ
Other
Enumeration date
06/12/2006
Last updated
03/09/2011
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