Organization
ADVANCED SPINE AND PAIN CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUKDEB DATTA M.D (MANAGER)
(615) 479-4692
Entity
Organization
Contact information
Practice address
1060 BROAD STREET, NEWARK, NJ 07102
(615) 472-4692
Mailing address
1 TREETOP CT, BERKELEY HEIGHTS, NJ 07922
Taxonomy
Speciality
Code
Description
License number
State
261QP3300X
Pain Clinic/Center
Primary
25MA08823500
NJ
Other
Enumeration date
04/01/2016
Last updated
04/01/2016
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