Organization
ADVANCED SPINE & SPORTS MEDICINE SPECIALIST LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BOQING CHEN (MANAGER)
(732) 902-6461
Entity
Organization
Contact information
Practice address
245 BRIDGE ST BLDG G, METUCHEN, NJ 08840-2294
(732) 902-6461
(732) 902-6463
Mailing address
245 BRIDGE ST BLDG G, METUCHEN, NJ 08840-2294
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
MA066877
NJ
208VP0014X
Interventional Pain Medicine Physician
Primary
MA066877
NJ
Other
Enumeration date
01/18/2012
Last updated
01/18/2012
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