Healthcare Provider Details

I. General information

NPI: 1609834050
Provider Name (Legal Business Name): TRI - COUNTY PAIN CARE P C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 03/16/2021
Certification Date: 03/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 MEDICAL CAMPUS DR STE 205
LANSDALE PA
19446-7205
US

IV. Provider business mailing address

12 VALLEY VIEW DR
NEWTOWN PA
18940-2730
US

V. Phone/Fax

Practice location:
  • Phone: 215-321-3737
  • Fax: 215-361-4999
Mailing address:
  • Phone: 215-321-3737
  • Fax: 215-361-4999

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JAY M MERGAMAN
Title or Position: OWNER
Credential: M.D.
Phone: 215-321-3737