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General NPI Number Information
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NPI Number | 1659760585
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Entity Type | Organization
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Legal Business Name | PA PAIN SPECIALISTS, PC
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Dates
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Enumeration Date | 01/15/2015
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Last Update Date | 01/15/2015
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Provider Practice Location Address
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Address Line | 101 S MAIN ST SUITE 201
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City | COOPERSBURG
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State | PA
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Zip | 18036-1965
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Country | US
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Telephone | 610-776-4746
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Fax | 610-776-4904
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Provider Business Mailing Address
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Address Line | 101 S MAIN ST SUITE 201
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City | COOPERSBURG
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State | PA
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Zip | 18036-1965
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Country | US
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Telephone | 610-776-4746
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Fax | 610-776-4904
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Authorized Official
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Title or Position | OWNER
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Name | GENE LEVINSTEIN
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Credential | M.D.
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Telephone | 610-776-4746
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332900000X
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Taxonomy Name | Non-Pharmacy Dispensing Site
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License Number | MD425455
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License Number State | PA
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