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General NPI Number Information
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NPI Number | 1912432972
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Entity Type | Organization
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Legal Business Name | PAIN INSTACARE
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Dates
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Enumeration Date | 04/27/2017
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Last Update Date | 03/08/2021
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Provider Practice Location Address
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Address Line | 1420 WALNUT STREET SUITE 1201
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City | PHILADELPHIA
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State | PA
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Zip | 19102-4017
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Country | US
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Telephone | 215-278-9937
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Fax |
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Provider Business Mailing Address
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Address Line | 100 SPRINGDALE RD STE B5
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City | CHERRY HILL
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State | NJ
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Zip | 08003-3366
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Country | US
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Telephone | 888-724-6121
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. RAJAN S GUPTA
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Credential | MD
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Telephone | 856-357-6053
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number | 25MA07713800
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License Number State | NJ
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