Provider Demographics
NPI:1073884383
Name:PAIN SOLUTIONS PLLC
Entity Type:Organization
Organization Name:PAIN SOLUTIONS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PRAVEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:SUCHDEV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-577-3003
Mailing Address - Street 1:21 EASTMAN AVE
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03110-6744
Mailing Address - Country:US
Mailing Address - Phone:603-647-2333
Mailing Address - Fax:
Practice Address - Street 1:21 EASTMAN AVE
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:NH
Practice Address - Zip Code:03110-6744
Practice Address - Country:US
Practice Address - Phone:603-647-2333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-18
Last Update Date:2012-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30211579Medicaid
NHRE6512OtherPTAN