Provider Demographics
NPI:1609834050
Name:TRI - COUNTY PAIN CARE P C
Entity Type:Organization
Organization Name:TRI - COUNTY PAIN CARE P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAY
Authorized Official - Middle Name:M
Authorized Official - Last Name:MERGAMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-321-3737
Mailing Address - Street 1:12 VALLEY VIEW DR
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-2730
Mailing Address - Country:US
Mailing Address - Phone:215-321-3737
Mailing Address - Fax:215-361-4999
Practice Address - Street 1:125 MEDICAL CAMPUS DR STE 205
Practice Address - Street 2:
Practice Address - City:LANSDALE
Practice Address - State:PA
Practice Address - Zip Code:19446-7205
Practice Address - Country:US
Practice Address - Phone:215-321-3737
Practice Address - Fax:215-361-4999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-03
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
059265Medicare ID - Type Unspecified