# ATLANTIC PAIN AND PHYSICAL MEDICINE PC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1578505830
- **Authorized official:** BRUCE M HAIRSTON M.D. (DOCTOR)
- **Authorized official phone:** (609) 652-3933

## Contact information

- **Practice address:** 236 E. JIMMIE LEEDS ROAD, SUITE A, GALLOWAY, NJ 08205-9599
- **Practice address phone:** (609) 652-3933
- **Practice address fax:** (609) 652-9409
- **Mailing address:** PO BOX 306, POMONA, NJ 08240-0306
- **Mailing address phone:** (609) 652-3933
- **Mailing address fax:** (609) 652-9409

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | 026341 | NJ | Yes |
| 208VP0000X | Pain Medicine Physician | 25MA068015 | NJ | — |

## Other

- **Enumeration date:** 06/12/2006
- **Last updated:** 03/09/2011