Provider Demographics
NPI:1508100157
Name:GREYSTONE PAIN MANAGEMENT INC
Entity Type:Organization
Organization Name:GREYSTONE PAIN MANAGEMENT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAA
Authorized Official - Middle Name:
Authorized Official - Last Name:ELREFAI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-266-8811
Mailing Address - Street 1:21 ROCKLAND ST
Mailing Address - Street 2:UNIT M
Mailing Address - City:CANTON
Mailing Address - State:MA
Mailing Address - Zip Code:02021-5104
Mailing Address - Country:US
Mailing Address - Phone:205-266-8811
Mailing Address - Fax:205-266-8811
Practice Address - Street 1:21 ROCKLAND ST
Practice Address - Street 2:UNIT M
Practice Address - City:CANTON
Practice Address - State:MA
Practice Address - Zip Code:02021
Practice Address - Country:US
Practice Address - Phone:205-266-8811
Practice Address - Fax:205-266-8811
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-20
Last Update Date:2014-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA520052084P2900X
MA152670207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty
Yes2084P2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPain MedicineGroup - Multi-Specialty