Provider Demographics
NPI:1083709604
Name:ADVANCED PAIN MANAGEMENT & ANESTHESIOLOGY, PC
Entity Type:Organization
Organization Name:ADVANCED PAIN MANAGEMENT & ANESTHESIOLOGY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BEHZAD
Authorized Official - Middle Name:
Authorized Official - Last Name:AALAEI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:219-769-7246
Mailing Address - Street 1:504 E 86TH AVE
Mailing Address - Street 2:
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-6213
Mailing Address - Country:US
Mailing Address - Phone:219-769-7246
Mailing Address - Fax:219-769-7217
Practice Address - Street 1:504 E. 86TH AVE
Practice Address - Street 2:
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-6213
Practice Address - Country:US
Practice Address - Phone:219-769-7246
Practice Address - Fax:219-769-7217
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2009-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN5408790001Medicare NSC
IN251810Medicare PIN