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General NPI Number Information
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NPI Number | 1497740963
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Entity Type | Organization
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Legal Business Name | CENTER FOR PAIN MEDICINE
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Dates
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Enumeration Date | 09/12/2005
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 2010 OLD WEST CHESTER PIKE STE 330
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City | HAVERTOWN
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State | PA
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Zip | 19083-2712
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Country | US
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Telephone | 717-263-5562
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Fax | 717-263-1566
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Provider Business Mailing Address
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Address Line | PO BOX 1250
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City | HAVERTOWN
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State | PA
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Zip | 19083-5850
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Country | US
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Telephone | 717-263-5562
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Fax | 717-263-1566
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Authorized Official
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Title or Position | PRESIDENT
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Name | WILLIAM ISAACSON
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Credential | MD
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Telephone | 610-789-8070
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number |
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License Number State | PA
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