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General NPI Number Information
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NPI Number | 1487428397
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Entity Type | Organization
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Legal Business Name | RELEVIUM PAIN AND VEIN LLC
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Dates
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Enumeration Date | 11/10/2023
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Last Update Date | 09/18/2025
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Provider Practice Location Address
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Address Line | 296 E BROWN ST STE D
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City | EAST STROUDSBURG
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State | PA
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Zip | 18301-3011
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Country | US
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Telephone | 973-200-4695
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Fax |
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Provider Business Mailing Address
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Address Line | 296 E BROWN ST STE D
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City | EAST STROUDSBURG
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State | PA
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Zip | 18301-3011
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Country | US
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Telephone | 570-445-2200
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Fax |
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | MARIAM SALISU
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Credential | MD
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Telephone | 570-445-2200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2471V0105X
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Taxonomy Name | Vascular Sonography Radiologic Technologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 246XC2903X
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Taxonomy Name | Vascular Specialist/Technologist Cardiovascular
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number |
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License Number State |
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