Healthcare Provider Details

I. General information

NPI: 1801541883
Provider Name (Legal Business Name): POST SURGICAL PAIN CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/17/2022
Last Update Date: 02/17/2022
Certification Date: 02/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 JUDGE TANNER BLVD STE 102
COVINGTON LA
70433-7504
US

IV. Provider business mailing address

101 JUDGE TANNER BLVD STE 102
COVINGTON LA
70433-7504
US

V. Phone/Fax

Practice location:
  • Phone: 504-327-5266
  • Fax: 724-252-2152
Mailing address:
  • Phone: 504-327-5266
  • Fax: 724-252-2152

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State

VIII. Authorized Official

Name: GREGORY KUM-NJI
Title or Position: OWNER
Credential: MD
Phone: 724-988-9028