# GARDEN STATE SPORTS & PAIN MEDICINE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Premier Pain and Spine Solutions, LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1821580747
- **Authorized official:** DR. TODD S. KOPPEL MD (PRESIDENT)
- **Authorized official phone:** (914) 666-8866

## Contact information

- **Practice address:** 721 CLIFTON AVE STE 2D, CLIFTON, NJ 07013-1880
- **Practice address phone:** (914) 666-8866
- **Mailing address:** 480 BEDFORD RD STE 4202, CHAPPAQUA, NY 10514-1716
- **Mailing address phone:** (914) 666-8866

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | NULL | Yes |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/06/2018
- **Last updated:** 11/02/2020