Provider Demographics
NPI:1629828587
Name:BOSTON PAIN SOLUTIONS PC
Entity Type:Organization
Organization Name:BOSTON PAIN SOLUTIONS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FREDERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:GERGES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:617-894-1506
Mailing Address - Street 1:29 SANDERSON RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02420-2618
Mailing Address - Country:US
Mailing Address - Phone:617-894-1506
Mailing Address - Fax:
Practice Address - Street 1:29 SANDERSON RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02420-2618
Practice Address - Country:US
Practice Address - Phone:617-894-1506
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-25
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty