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Organization

PAIN ASSOCIATES OF BERGEN COUNTY LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SAMYADEV DATTA MD (OWNER)
(201) 525-0002
Entity
Organization

Contact information

Practice address
294 STATE STREET, SUITE 2, HACKENSACK, NJ 07601
(201) 525-0002
Mailing address
294 STATE ST, SUITE 2, HACKENSACK, NJ 07601
(201) 488-7246

Taxonomy

Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
25MA07161100
NJ

Other

Enumeration date
11/27/2017
Last updated
05/10/2018
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