Provider Demographics
NPI:1235297854
Name:ADVANCED SPINE AND PAIN MANAGEMENT, INC.
Entity Type:Organization
Organization Name:ADVANCED SPINE AND PAIN MANAGEMENT, INC.
Other - Org Name:NEW ENGLAND SPINE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ADRIAN
Authorized Official - Middle Name:KARL
Authorized Official - Last Name:HAMBURGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:401-348-3865
Mailing Address - Street 1:25 WELLS ST
Mailing Address - Street 2:
Mailing Address - City:WESTERLY
Mailing Address - State:RI
Mailing Address - Zip Code:02891-2922
Mailing Address - Country:US
Mailing Address - Phone:401-348-3865
Mailing Address - Fax:401-348-3641
Practice Address - Street 1:25 WELLS ST
Practice Address - Street 2:
Practice Address - City:WESTERLY
Practice Address - State:RI
Practice Address - Zip Code:02891-2922
Practice Address - Country:US
Practice Address - Phone:401-348-3865
Practice Address - Fax:401-348-3641
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2013-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI729005461Medicare PIN