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Organization

PROFESSIONAL DIAGNOSTIC SPECIALISTS,

Active
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Organization

PROFESSIONAL DIAGNOSTIC SPECIALISTS,

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. IGOR PRIVEN M.D. (MEDICAL DIRECTOR)
(718) 896-6443
Entity
Organization

Contact information

Practice address
345 US HIGHWAY 9, SUITE 8, MANALAPAN, NJ 07726-3239
(732) 845-2200
(732) 837-4514
Mailing address
4 WINTERBERRY CT, MARLBORO, NJ 07746
(718) 986-6443
(732) 837-4514

Taxonomy

Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary

Other

Enumeration date
11/22/2010
Last updated
12/21/2011
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