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General NPI Number Information
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NPI Number | 1508167446
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Entity Type | Organization
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Legal Business Name | PISZEL PAIN MANAGEMENT SYSTEM LLC
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Dates
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Enumeration Date | 11/09/2010
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Last Update Date | 09/29/2011
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Provider Practice Location Address
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Address Line | 50 E MAIN ST
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City | GENEVA
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State | OH
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Zip | 44041-1347
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Country | US
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Telephone | 440-361-4610
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Fax | 440-446-0203
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Provider Business Mailing Address
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Address Line | 50 E MAIN ST
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City | GENEVA
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State | OH
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Zip | 44041-1347
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Country | US
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Telephone | 440-361-4610
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Fax | 440-466-0203
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Authorized Official
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Title or Position | OWNER
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Name | DR. BRUCE A PISZEL
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Credential | MD
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Telephone | 440-361-4610
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 1938092
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License Number State | OH
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