Healthcare Provider Details

I. General information

NPI: 1821581737
Provider Name (Legal Business Name): NOVUS PAIN MANAGEMENT - PENNSYLVANIA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2018
Last Update Date: 09/22/2025
Certification Date: 09/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 ABBEYVILLE RD
LANCASTER PA
17603-4604
US

IV. Provider business mailing address

157 BALTIMORE ST STE 104
CUMBERLAND MD
21502-2472
US

V. Phone/Fax

Practice location:
  • Phone: 301-722-0484
  • Fax: 833-903-0130
Mailing address:
  • Phone: 301-722-0484
  • Fax: 833-903-0130

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: HEATHER ROBOSSON
Title or Position: OFFICE MANAGER
Credential:
Phone: 301-722-0484