Organization
INNOVATIVE SPINE AND PAIN CENTER, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VANNY LE M.D. (VICE PRESIDENT)
(609) 915-6865
Entity
Organization
Contact information
Practice address
90 BERGEN ST, SUITE 3400, NEWARK, NJ 07103-2425
(973) 972-2085
Mailing address
4 MARCIN WAY, FLANDERS, NJ 07836-9671
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
25MA08859900
NJ
Other
Enumeration date
08/12/2016
Last updated
08/12/2016
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