Organization
PAIN ASSOCIATES OF BERGEN COUNTY LLC
Active
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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