Organization
PAIN RELIEF CENTER OF AMERICA, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSE ROQUE (PRESIDENT)
(201) 869-3000
Entity
Organization
Contact information
Practice address
211 60TH ST, 2ND FLOOR, WEST NEW YORK, NJ 07093-2805
(201) 869-3000
(201) 869-3001
Mailing address
211 60TH ST, 2ND FLOOR, WEST NEW YORK, NJ 07093-2805
(201) 869-3000
(201) 869-3001
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
0400146384
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1629188503
NPI
—
05
—
77331001
—
NJ
Enumeration date
10/20/2006
Last updated
08/22/2020
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