Organization
PARK AVENUE PAIN MANAGEMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PRAMILA BYAHATTI MD (DITACTOR)
(908) 279-8462
Entity
Organization
Contact information
Practice address
2509 PARK AVE, SUITE 1A, SOUTH PLAINFIELD, NJ 07080-5300
(908) 279-8462
(732) 605-1238
Mailing address
P.O.BOX 959, SOUTH PLAINFIELD, NJ 07080-5530
(908) 279-8462
(732) 605-1238
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
25MA04131700
NJ
207L00000X
Anesthesiology Physician
Primary
MA030896
NJ
Other
Enumeration date
03/05/2009
Last updated
04/07/2010
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