Provider Demographics
NPI:1619359122
Name:PAIN RELIEF, INC.
Entity Type:Organization
Organization Name:PAIN RELIEF, INC.
Other - Org Name:PRI
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MAURIZIO
Authorized Official - Middle Name:Z
Authorized Official - Last Name:ALBALA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:920-637-1435
Mailing Address - Street 1:69 E FOX POINT DR
Mailing Address - Street 2:
Mailing Address - City:LITTLE CHUTE
Mailing Address - State:WI
Mailing Address - Zip Code:54911-4105
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7520 US HIGHWAY 51
Practice Address - Street 2:NWBJ
Practice Address - City:MINOCQUA
Practice Address - State:WI
Practice Address - Zip Code:54548-8943
Practice Address - Country:US
Practice Address - Phone:920-427-8271
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-19
Last Update Date:2015-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI55475-020208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1011622200001Medicaid
I07165Medicare UPIN