Organization
NASPAC1 LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RENEE BOGDOL (REVENUE CYCLE DIRECTOR)
(609) 845-3988
Entity
Organization
Contact information
Practice address
240 CENTRAL AVE FL 5, EAST ORANGE, NJ 07018-3313
(973) 573-7677
Mailing address
240 CENTRAL AVE FL 5, EAST ORANGE, NJ 07018-3313
(973) 573-7677
Taxonomy
Speciality
Code
Description
License number
State
2084N0600X
Clinical Neurophysiology Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Enumeration date
08/31/2021
Last updated
11/11/2025
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