Healthcare Provider Details
I. General information
NPI: 1548239551
Provider Name (Legal Business Name): CENTER FOR PAIN RELIEF, PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/14/2006
Last Update Date: 05/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3402 WASHINGTON RD
MC MURRAY PA
15317-2964
US
IV. Provider business mailing address
3402 WASHINGTON RD
MC MURRAY PA
15317-2964
US
V. Phone/Fax
- Phone: 724-942-5188
- Fax: 724-942-5878
- Phone: 724-942-5188
- Fax: 724-942-5878
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208VP0000X |
| Taxonomy | Pain Medicine Physician |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
| # 1 | |
| Identifier | 1007304770003 |
| Identifier Type | MEDICAID |
| Identifier State | PA |
| Identifier Issuer | |
VIII. Authorized Official
Name:
JAY
L
KARPEN
Title or Position: OWNER/FOUNDER
Credential: MD
Phone: 724-942-5188