Organization
INTERVENTIONAL PAIN MEDICINE OF NEW JERSEY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH PARK MD (MEDICAL DIRECTOR)
(201) 487-7246
Entity
Organization
Contact information
Practice address
680 KINDERKAMACK RD, ORADELL, NJ 07649-1600
(201) 487-7246
Mailing address
PO BOX 95000, CL # 4430, PHILADELPHIA, PA 19195-4430
(201) 804-2800
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
—
—
Other
Enumeration date
05/12/2010
Last updated
05/12/2010
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