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General NPI Number Information
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NPI Number | 1255623880
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Entity Type | Organization
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Legal Business Name | PAIN INSTITUTE OF CENTRAL PA PC
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Dates
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Enumeration Date | 05/16/2011
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Last Update Date | 02/19/2021
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Provider Practice Location Address
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Address Line | 69 ST PAUL DR STE B
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City | CHAMBERSBURG
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State | PA
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Zip | 17201-1020
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Country | US
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Telephone | 717-218-8800
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Fax | 717-552-2196
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Provider Business Mailing Address
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Address Line | 69 ST PAUL DR STE B
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City | CHAMBERSBURG
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State | PA
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Zip | 17201-1020
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Country | US
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Telephone | 717-218-8800
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Fax | 717-552-2196
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Authorized Official
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Title or Position | PHYSICIAN
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Name | ALI YOUSUFUDDIN
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Credential | MD
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Telephone | 717-218-8800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | MD422419
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | MD422419
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License Number State | PA
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