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General NPI Number Information
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NPI Number | 1821390923
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Entity Type | Organization
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Legal Business Name | GREATER PHILADELPHIA PAIN MANAGEMENT CENTER P.C.
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Dates
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Enumeration Date | 11/22/2010
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Last Update Date | 05/12/2011
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Provider Practice Location Address
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Address Line | 2612 RHAWN ST
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City | PHILADELPHIA
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State | PA
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Zip | 19152-3415
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Country | US
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Telephone | 215-338-8555
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Fax | 215-338-8031
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Provider Business Mailing Address
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Address Line | 104 BAILEY DR
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City | NORTH WALES
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State | PA
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Zip | 19454-4526
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Country | US
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Telephone | 215-962-6031
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Fax | 215-957-5401
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Authorized Official
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Title or Position | PHYSICIAN
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Name | GENE LEVINSTEIN
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Credential | MD
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Telephone | 215-957-5400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC007401L
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License Number State | PA
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