| Advanced Spine And Pain Llc | |
|
2 8th St Hammonton NJ 08037-3347 | |
| (888) 985-2727 | |
| (856) 779-0211 |
| Full Name | Advanced Spine And Pain Llc |
|---|---|
| Speciality | Pain Medicine |
| Location | 2 8th St, Hammonton, New Jersey |
| Authorized Official Name and Position | Damean Freas (CEO) |
| Authorized Official Contact | 8889852727 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Spine And Pain Llc 201 Defense Hwy Ste 260 Annapolis MD 21401-7096 Ph: (888) 985-2727 | Advanced Spine And Pain Llc 2 8th St Hammonton NJ 08037-3347 Ph: (888) 985-2727 |
| NPI Number | 1730359084 |
|---|---|
| Provider Enumeration Date | 03/03/2008 |
| Last Update Date | 02/25/2025 |
| Certification Date | 02/25/2025 |
| Medicare PECOS PAC ID | 0648358234 |
|---|---|
| Medicare Enrollment ID | O20080423000019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730359084 | NPI | - | NPPES |
| Provider Name | Syed N Ahsan |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1043262751 PECOS PAC ID: 5890788657 Enrollment ID: I20040407000005 |
| Provider Name | John J Mahoney |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1184660474 PECOS PAC ID: 0244122752 Enrollment ID: I20040514000537 |
| Provider Name | Robert Harris Salvage |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1386671436 PECOS PAC ID: 5294727566 Enrollment ID: I20040519000128 |
| Provider Name | Keith Radbill |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861557795 PECOS PAC ID: 3779565205 Enrollment ID: I20040607001006 |
| Provider Name | Russell Abrams |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1114956505 PECOS PAC ID: 6103807722 Enrollment ID: I20050317000894 |
| Provider Name | Shailen Jalali |
|---|---|
| Provider Type | Practitioner - Interventional Pain Management |
| Provider Identifiers | NPI Number: 1427021351 PECOS PAC ID: 9133171218 Enrollment ID: I20060202000632 |
| Provider Name | Nola T Mahoney |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235182692 PECOS PAC ID: 7416960901 Enrollment ID: I20060731000175 |
| Provider Name | Young J Lee |
|---|---|
| Provider Type | Practitioner - Interventional Pain Management |
| Provider Identifiers | NPI Number: 1609068659 PECOS PAC ID: 3274611868 Enrollment ID: I20080512000570 |
| Provider Name | Robert T Rinnier |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1386962785 PECOS PAC ID: 3678604147 Enrollment ID: I20100628000124 |
| Provider Name | Salvatore Russomano |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1326097874 PECOS PAC ID: 4880726462 Enrollment ID: I20101026000140 |
| Provider Name | Eileen R Manabat |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1548380124 PECOS PAC ID: 6002095775 Enrollment ID: I20110126001173 |
| Provider Name | Ijeoma C Menkiti |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225348873 PECOS PAC ID: 4981883360 Enrollment ID: I20110201000661 |
| Provider Name | Emily Rhee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649556713 PECOS PAC ID: 3375719610 Enrollment ID: I20120109000060 |
| Provider Name | Maryann E Masci |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427330141 PECOS PAC ID: 8123288750 Enrollment ID: I20120320000088 |
| Provider Name | Miteswar Purewal |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1750320461 PECOS PAC ID: 1759305428 Enrollment ID: I20130108000106 |
| Provider Name | Chioma A Ezeadichie |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1023267465 PECOS PAC ID: 8921243767 Enrollment ID: I20130326000462 |
| Provider Name | Erin E Intessimoni |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720414071 PECOS PAC ID: 4981833415 Enrollment ID: I20140204000719 |
| Provider Name | Uplekh S Purewal |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1548203839 PECOS PAC ID: 1658395546 Enrollment ID: I20141224000761 |
| Provider Name | Peter G Pryzbylkowski |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1174751929 PECOS PAC ID: 6608093018 Enrollment ID: I20160229000100 |
| Provider Name | Johan Reyes |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1750680948 PECOS PAC ID: 9335435692 Enrollment ID: I20160913000866 |
| Provider Name | Lanae Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922277995 PECOS PAC ID: 3577629013 Enrollment ID: I20180328000097 |
| Provider Name | Amy Marie Fletcher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114438439 PECOS PAC ID: 8325302136 Enrollment ID: I20180502002769 |
| Provider Name | Victoria Schenk Newbold |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093837643 PECOS PAC ID: 4789623265 Enrollment ID: I20180831000798 |
| Provider Name | Addison Haskins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114429107 PECOS PAC ID: 4486905031 Enrollment ID: I20180921000443 |
| Provider Name | Devin H Oakes |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1932447729 PECOS PAC ID: 5294003984 Enrollment ID: I20230906000607 |
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