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General NPI Number Information
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NPI Number | 1780678045
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Entity Type | Organization
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Legal Business Name | PAIN MEDICINE AND REHABILITATION SPECIALISTS
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Dates
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Enumeration Date | 09/01/2005
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Last Update Date | 06/23/2008
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Provider Practice Location Address
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Address Line | 160 N POINTE BLVD SUITE 115
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City | LANCASTER
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State | PA
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Zip | 17601-4134
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Country | US
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Telephone | 717-560-4480
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Fax | 717-560-4485
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Provider Business Mailing Address
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Address Line | 160 N POINTE BLVD SUITE 115
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City | LANCASTER
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State | PA
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Zip | 17601-4134
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Country | US
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Telephone | 717-560-4480
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Fax | 717-560-4485
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. RANDY A COHEN
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Credential | DO
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Telephone | 717-560-4480
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 05006774E
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License Number State | PA
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