Provider Demographics
NPI:1639471097
Name:PENNSYLVANIA PAIN SPECIALISTS, PC
Entity Type:Organization
Organization Name:PENNSYLVANIA PAIN SPECIALISTS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GENE
Authorized Official - Middle Name:V
Authorized Official - Last Name:LEVINSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-776-4746
Mailing Address - Street 1:2980 N BEVERLY GLEN CIR
Mailing Address - Street 2:STE 301
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90077-1726
Mailing Address - Country:US
Mailing Address - Phone:310-474-9809
Mailing Address - Fax:
Practice Address - Street 1:451 W CHEW ST
Practice Address - Street 2:SUITE 405
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18102-3472
Practice Address - Country:US
Practice Address - Phone:610-776-4746
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PENNSYLVANIA PAIN SPECIALISTS, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-11-17
Last Update Date:2011-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site