Organization
KERD PAIN MANAGEMENT PRACTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DMITRIY DVOSKIN M.D. (PRESIDENT)
(347) 228-1065
Entity
Organization
Contact information
Practice address
776 NORTHFIELD AVE STE 101, WEST ORANGE, NJ 07052-1140
(347) 228-1065
Mailing address
100 OLD PALISADE RD APT 3910, FORT LEE, NJ 07024-7029
(347) 228-1065
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
Primary
—
—
Other
Enumeration date
01/08/2024
Last updated
01/08/2024
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