OrganizationActive
Modern Spine and Pain PC
NPI 1174240352 · Pain Medicine Physician · West Deptford, NJ
Provider details
- NPI number
- 1174240352
- Entity type
- Organization
- Primary specialty
- Pain Medicine PhysicianAllopathic & Osteopathic Physicians
- Authorized official
- Amanda Ricca, Administrator
Practice location
196 Grove Ave Ste E
West Deptford, NJ 08086-2139
Phone: (856) 900-0041
Mailing address
Po Box 358
Douglassville, PA 19518-0358
Registry dates
- Enumerated
- 2022-10-27
- Last updated
- 2023-02-24
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.