Basic Information
| Provider Information | |||||||||
| NPI: | 1982044194 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | RAMAPO PAIN MANAGEMENT AND SPORTS MEDICINE, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 100 ROUTE 59 STE 111 | ||||||||
| Address2: | |||||||||
| City: | SUFFERN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 109014927 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8453575775 | ||||||||
| FaxNumber: | 8453575777 | ||||||||
| Practice Location | |||||||||
| Address1: | 100 ROUTE 59 STE 111 | ||||||||
| Address2: | |||||||||
| City: | SUFFERN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 10901 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8453575745 | ||||||||
| FaxNumber: | 8453575751 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/02/2013 | ||||||||
| LastUpdateDate: | 08/28/2018 | ||||||||
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| AuthorizedOfficialLastName: | CLARKIN | ||||||||
| AuthorizedOfficialFirstName: | RICHARD | ||||||||
| AuthorizedOfficialMiddleName: | P. | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8453575775 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207LP2900X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine | 2081S0010X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | Sports Medicine | 208VP0014X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pain Medicine | Interventional Pain Medicine |
No ID Information.