Provider Demographics
NPI:1326033994
Name:KOENIGSBERG & ASSOCIATES PAIN MANAGEMENT LLC
Entity Type:Organization
Organization Name:KOENIGSBERG & ASSOCIATES PAIN MANAGEMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DON
Authorized Official - Middle Name:A
Authorized Official - Last Name:KOENIGSBERG
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:215-467-7212
Mailing Address - Street 1:2222 S BROAD ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19145-3948
Mailing Address - Country:US
Mailing Address - Phone:215-467-7212
Mailing Address - Fax:215-467-7216
Practice Address - Street 1:2222 S BROAD ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19145-3948
Practice Address - Country:US
Practice Address - Phone:215-467-7212
Practice Address - Fax:215-467-7216
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1010771660001Medicaid
PA081210Medicare PIN