Provider Demographics
NPI:1609247741
Name:PAIN, SPINE, AESTHETIC AND WELLNESS CENTER, PC
Entity Type:Organization
Organization Name:PAIN, SPINE, AESTHETIC AND WELLNESS CENTER, PC
Other - Org Name:SURGERY CENTER @ LINDEN POINTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/COO
Authorized Official - Prefix:DR
Authorized Official - First Name:ASHRAF
Authorized Official - Middle Name:
Authorized Official - Last Name:RAZZAK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:724-308-7401
Mailing Address - Street 1:3055 INNOVATION WAY
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:PA
Mailing Address - Zip Code:16148-7905
Mailing Address - Country:US
Mailing Address - Phone:724-308-7401
Mailing Address - Fax:724-221-3807
Practice Address - Street 1:3055 INNOVATION WAY
Practice Address - Street 2:
Practice Address - City:HERMITAGE
Practice Address - State:PA
Practice Address - Zip Code:16148-7905
Practice Address - Country:US
Practice Address - Phone:724-308-7401
Practice Address - Fax:724-221-3807
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PAIN, SPINE, AESTHETIC AND WELLNESS CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-10-15
Last Update Date:2015-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical