Organization
EDISON SPINE & PAIN CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUKDEB DATTA MD, MBA (PRESIDENT)
(615) 479-4692
Entity
Organization
Contact information
Practice address
940 AMBOY AVE STE 103, EDISON, NJ 08837-2869
(347) 380-9138
Mailing address
940 AMBOY AVE STE 103, EDISON, NJ 08837-2869
Taxonomy
Speciality
Code
Description
License number
State
261QP3300X
Pain Clinic/Center
Primary
25MA08823500
NJ
Other
Enumeration date
05/11/2018
Last updated
05/11/2018
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