Provider Demographics
NPI:1114466349
Name:NERVE PAIN CENTERS OF WESTERN PENNSYLVANIA
Entity Type:Organization
Organization Name:NERVE PAIN CENTERS OF WESTERN PENNSYLVANIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:J
Authorized Official - Last Name:MORREALE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:412-860-3146
Mailing Address - Street 1:874 BUTLER ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15223-1331
Mailing Address - Country:US
Mailing Address - Phone:412-860-3146
Mailing Address - Fax:
Practice Address - Street 1:874 BUTLER ST
Practice Address - Street 2:SUITE 1
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15223-1331
Practice Address - Country:US
Practice Address - Phone:412-860-3146
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-21
Last Update Date:2017-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD449496207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty