Provider Demographics
NPI:1558701789
Name:PAIN MANAGEMENT CENTERS OF NEW ENGLAND, LLC
Entity Type:Organization
Organization Name:PAIN MANAGEMENT CENTERS OF NEW ENGLAND, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:R
Authorized Official - Last Name:BRANTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:978-304-8690
Mailing Address - Street 1:480 MAPLE ST
Mailing Address - Street 2:SUITE C233A
Mailing Address - City:DANVERS
Mailing Address - State:MA
Mailing Address - Zip Code:01923-4065
Mailing Address - Country:US
Mailing Address - Phone:978-304-8690
Mailing Address - Fax:978-304-8697
Practice Address - Street 1:480 MAPLE ST
Practice Address - Street 2:SUITE C233A
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923-4065
Practice Address - Country:US
Practice Address - Phone:978-304-8690
Practice Address - Fax:978-304-8697
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BEVERLY ANESTHESIA ASSOCIATES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-07-02
Last Update Date:2014-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty