Bayshore Pain Management LLC

NPI #1093110017 in Keyport, New Jersey

Provider Information

NPI Number: 1093110017
Entity Type: Organization
Organization Name: Bayshore Pain Management LLC
Primary Specialty: Specialist
Enumeration Date: Nov 3, 2014
Last Updated: Nov 3, 2014

Practice Location

Address: 250 MAPLE PL
City: Keyport
State: New Jersey
ZIP Code: 07735-1144
Phone: (732) 264-8900

Authorized Official

Name: CHARLES DIETRICH
Title: ADMINISTRATOR
Phone: (732) 264-8900

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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