# NASPAC-NJ PLLC

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

## Provider details

- **NPI number:** 1972151207
- **Authorized official:** RENEE BOGDOL AM (DIRECTOR REVENUE CYCLE)
- **Authorized official phone:** (609) 845-3988

## Contact information

- **Practice address:** 2325 MARYLAND RD STE 100, WILLOW GROVE, PA 19090-1758
- **Practice address phone:** (215) 657-1315
- **Practice address fax:** (215) 659-8964
- **Mailing address:** 404 CREEK CROSSING BLVD STE 404, HAINESPORT, NJ 08036-2768
- **Mailing address phone:** (609) 845-3988
- **Mailing address fax:** (609) 288-6078

## 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:** 08/29/2019
- **Last updated:** 04/01/2026