Healthcare Provider Details

I. General information

NPI: 1780907444
Provider Name (Legal Business Name): NESHAMINY PAIN MANAGEMENT CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2010
Last Update Date: 06/10/2022
Certification Date: 06/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2440 BRISTOL RD
BENSALEM PA
19020-6002
US

IV. Provider business mailing address

NESHAMINY VALLEY PAIN MANAGEMENT CENTER PC 600 LOUIS DRIVE SUITE 202
WARMINSTER PA
18974
US

V. Phone/Fax

Practice location:
  • Phone: 215-891-9955
  • Fax: 215-891-9655
Mailing address:
  • Phone: 215-957-5400
  • Fax: 215-957-5401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State

VIII. Authorized Official

Name: BRIAN M BAYZICK
Title or Position: COO
Credential:
Phone: 215-957-5400