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General NPI Number Information
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NPI Number | 1154749497
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Entity Type | Organization
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Legal Business Name | CONSULTANTS IN PAIN MANAGEMENT
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Dates
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Enumeration Date | 04/03/2014
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Last Update Date | 10/29/2015
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Provider Practice Location Address
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Address Line | 2409 STATE ST 2ND FLOOR
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City | ERIE
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State | PA
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Zip | 16503-1856
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Country | US
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Telephone | 814-459-0585
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Fax | 814-455-0239
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Provider Business Mailing Address
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Address Line | 2409 STATE ST 2ND FLOOR
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City | ERIE
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State | PA
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Zip | 16503-1856
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Country | US
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Telephone | 814-459-0585
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Fax | 814-455-0239
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Authorized Official
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Title or Position | PRACTICE ADMIN
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Name | GINA MARIE DILUZIO
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Credential |
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Telephone | 814-459-0585
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number |
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State | PA
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