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Organization

FAIR LAWN PAIN MANAGEMENT LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
VIJAY GUPTA MD (PRESIDENT)
(973) 777-5444
Entity
Organization

Contact information

Practice address
28-06 BROADWAY, FAIR LAWN, NJ 07410-3913
(201) 475-8940
Mailing address
1117 ROUTE 46, SUITE 201, CLIFTON, NJ 07013-2449
(973) 777-5444

Taxonomy

Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
25MA08578900
NJ

Other

Enumeration date
07/15/2015
Last updated
07/15/2015
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