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NPI Code Detail

MEDICARE: PAIN MANAGEMENT CLINIC

MEDICARE: PAIN MANAGEMENT CLINIC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialistMD064551LPA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1114229895
Entity Type Code : Organization
Provider Name (Legal Business Name) : PAIN MANAGEMENT CLINIC
Provider Business Mailing Address
First Line : PO BOX 8157
Second Line :
City : NEW CASTLE
State : PA
Zip : 16107-8157
Country : US
Telephone Number : 724-657-9262
Fax Number : 724-657-9261
Provider Business Practice Location Address
First Line : 401 N JEFFERSON ST
Second Line :
City : NEW CASTLE
State : PA
Zip : 16101-2238
Country : US
Telephone Number : 724-657-9262
Fax Number : 724-657-9261
Authorized Official
Title or Position : PROPRIETOR
Name : DR. ASHRAF RAZZAK
Credential : M.D.
Telephone Number : 724-657-9262
Provider Enumeration Date : 12/01/2010
Last Update Date : 12/01/2010

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Directions to “PAIN MANAGEMENT CLINIC ” Practice Location

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