Provider Demographics
NPI:1407244890
Name:COMFORT INTERVENTIONAL PAIN CENTER, LLC
Entity Type:Organization
Organization Name:COMFORT INTERVENTIONAL PAIN CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN ASSISTANT
Authorized Official - Prefix:MR
Authorized Official - First Name:PIUS
Authorized Official - Middle Name:
Authorized Official - Last Name:AFRIYIE
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:443-410-3309
Mailing Address - Street 1:1406B CRAIN HWY S
Mailing Address - Street 2:SUITE 208
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-4099
Mailing Address - Country:US
Mailing Address - Phone:443-410-3309
Mailing Address - Fax:
Practice Address - Street 1:1406B CRAIN HWY S
Practice Address - Street 2:SUITE 208
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-4099
Practice Address - Country:US
Practice Address - Phone:443-410-3309
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-07
Last Update Date:2015-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0004208261QP3300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain