Provider Demographics
NPI:1033589650
Name:PAIN MEDICINE OF YORK, LLC
Entity Type:Organization
Organization Name:PAIN MEDICINE OF YORK, LLC
Other - Org Name:ALL BETTER WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:FLORENTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:MAYKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-467-4055
Mailing Address - Street 1:1497A S. QUEEN STREET
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403
Mailing Address - Country:US
Mailing Address - Phone:717-848-3979
Mailing Address - Fax:717-668-8967
Practice Address - Street 1:233 EASTERLY PKWY STE 100
Practice Address - Street 2:
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16801-6300
Practice Address - Country:US
Practice Address - Phone:717-848-3979
Practice Address - Fax:717-668-8967
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-26
Last Update Date:2019-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA121683Medicare PIN