Organization
GARDEN STATE NEURO STIMULATION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUKDEB DATTA MD (PRESIDENT)
(615) 479-4692
Entity
Organization
Contact information
Practice address
3657 ALBANY POST RD, POUGHKEEPSIE, NY 12601-1177
(212) 430-0312
(908) 934-9298
Mailing address
47 WOODLAND AVE, APT 301, SUMMIT, NJ 07901-2175
(615) 479-4692
(908) 934-9298
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
2590151
NY
Other
Enumeration date
05/07/2012
Last updated
05/07/2012
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