Organization
PAIN MANAGEMENT & REJUVENATION CLINIC USA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CLARICIO DECASTRO PEGUERO MD (OWNER)
(551) 204-2543
Entity
Organization
Contact information
Practice address
1209 SUMMIT AVE UNIT 102, JERSEY CITY, NJ 07307-3170
(201) 714-4683
(201) 742-0084
Mailing address
154 ORANGEBURGH RD, OLD TAPPAN, NJ 07675-7499
(201) 714-4683
(201) 742-0084
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
—
Other
Enumeration date
02/16/2022
Last updated
10/15/2024
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