Provider Demographics
NPI:1538189386
Name:PAIN CONTROL ASSOCIATES P C
Entity type:Organization
Organization Name:PAIN CONTROL ASSOCIATES P C
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:P
Authorized Official - Last Name:PLOTNICK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-744-7176
Mailing Address - Street 1:PO BOX 318
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-0318
Mailing Address - Country:US
Mailing Address - Phone:609-587-7775
Mailing Address - Fax:609-587-7955
Practice Address - Street 1:1001 LAUREL OAK RD STE A2
Practice Address - Street 2:
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-3512
Practice Address - Country:US
Practice Address - Phone:856-566-8600
Practice Address - Fax:856-566-8666
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-21
Last Update Date:2018-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ2590103TC0700X
NJNR093183363L00000X
208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ115656200OtherACS
NJ7554260003OtherMEDICARE NSC
NJ7554260004OtherMEDICARE NSC
NJP621085OtherOXFORD
NJ0944197OtherAETNA
NJ7554260001OtherMEDICARE NSC
NJ7554260002OtherMEDICARE NSC
NJ0508138000OtherAMERIHEALTH
NJ0944197OtherAETNA
NJ7554260003OtherMEDICARE NSC