Organization
BERGEN PAIN CLINIC LLC
Active
Organization
BERGEN PAIN CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIEVIC BALAAG EBORA FERNANDO PT,DPT (MANAGER)
(201) 408-5016
Entity
Organization
Contact information
Practice address
333 SYLVAN AVE STE 326, ENGLEWOOD CLIFFS, NJ 07632-2724
(201) 408-5016
Mailing address
333 SYLVAN AVE STE 326, ENGLEWOOD CLIFFS, NJ 07632-2724
(201) 408-5016
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
—
—
225100000X
Physical Therapist
—
—
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
12/10/2018
Last updated
12/10/2018
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