Basic Information
| Provider Information | |||||||||
| NPI: | 1790891356 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MANHATTAN SPINE & PAIN MEDICINE , P. C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 540 BORDENTOWN AVE | ||||||||
| Address2: | 2ND FLOOR | ||||||||
| City: | SOUTH AMBOY | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 088791544 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7327217227 | ||||||||
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| Practice Location | |||||||||
| Address1: | 115 E 57TH ST | ||||||||
| Address2: | STE 610 | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100222049 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2125353505 | ||||||||
| FaxNumber: | 2125353568 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/23/2006 | ||||||||
| LastUpdateDate: | 02/24/2010 | ||||||||
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| AuthorizedOfficialLastName: | BAKSHI | ||||||||
| AuthorizedOfficialFirstName: | SANJAY | ||||||||
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| AuthorizedOfficialTitleorPosition: | PHYSICIAN | ||||||||
| AuthorizedOfficialTelephone: | 2125353505 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207LP2900X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine |
No ID Information.