# NASPAC NJ PLLC

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

## Provider details

- **NPI number:** 1629648449
- **Authorized official:** RENEE BOGDOL (DIRECTOR REVENUE CYCLE)
- **Authorized official phone:** (609) 845-3988

## Contact information

- **Practice address:** 100 PRESIDENTIAL BLVD STE 300, BALA CYNWYD, PA 19004-1108
- **Practice address phone:** (484) 436-2123
- **Practice address fax:** (484) 436-2338
- **Mailing address:** 100 PRESIDENTIAL BLVD STE 300, BALA CYNWYD, PA 19004-1108
- **Mailing address phone:** (484) 436-2123
- **Mailing address fax:** (484) 436-2338

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | NULL | Yes |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | — | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 3336C0002X | Clinic Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 06/25/2021
- **Last updated:** 04/14/2026