Organization
ADVANCED SPINE PAIN THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHINWEIKE IZEOGU MD (MEDICAL DIRECTOR)
(973) 673-0601
Entity
Organization
Contact information
Practice address
290 S LIVINGSTON AVE STE 1, LIVINGSTON, NJ 07039-3986
(973) 673-0601
(973) 533-0958
Mailing address
290 S LIVINGSTON AVE STE 1, LIVINGSTON, NJ 07039-3986
(973) 673-0601
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
—
Other
Enumeration date
11/03/2017
Last updated
11/23/2020
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