Organization
INNOVATIVE SPINE AND PAIN CENTER, P.C.
Active
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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