Organization
STATE NEURODIAGNOSTICS AND PAIN MANAGMENT LLC
Active
Organization
STATE NEURODIAGNOSTICS AND PAIN MANAGMENT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BARRY D FASS MD (OWNER)
(267) 265-6750
Entity
Organization
Contact information
Practice address
6650 BROWNING RD, SUITE U12, PENNSAUKEN, NJ 08109-1479
(856) 910-1990
(609) 587-2277
Mailing address
111 COLFAX RD, SKILLMAN, NJ 08558
(267) 265-6750
(609) 466-5494
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
—
—
Other
Enumeration date
07/09/2008
Last updated
12/02/2009
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