Healthcare Provider Details
I. General information
NPI: 1740531565
Provider Name (Legal Business Name): PAIN SOLUTIONS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/20/2012
Last Update Date: 09/20/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
14 MAPLE ST
GILFORD NH
03249-6580
US
IV. Provider business mailing address
21 EASTMAN AVE
BEDFORD NH
03110-6744
US
V. Phone/Fax
- Phone: 603-524-2073
- Fax: 603-524-1715
- Phone: 603-647-2333
- Fax: 603-647-2316
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207LP2900X |
| Taxonomy | Pain Medicine (Anesthesiology) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
PRAVEEN
K
SUCHDEV
Title or Position: PRESIDENT/CEO
Credential: M.D.
Phone: 603-577-3003