Provider Demographics
NPI:1689600967
Name:PAIN RESOLUTION, P.C.
Entity Type:Organization
Organization Name:PAIN RESOLUTION, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:RUZANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:BOGATI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-420-4591
Mailing Address - Street 1:226 EAGLE VALLEY MALL
Mailing Address - Street 2:
Mailing Address - City:EAST STROUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18301-1315
Mailing Address - Country:US
Mailing Address - Phone:570-420-4591
Mailing Address - Fax:570-421-2174
Practice Address - Street 1:226 EAGLE VALLEY MALL
Practice Address - Street 2:
Practice Address - City:EAST STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18301-1315
Practice Address - Country:US
Practice Address - Phone:570-420-4591
Practice Address - Fax:570-421-2174
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY211244-1207R00000X
PAMD065515L2081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Not Answered2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG79401Medicare UPIN
NY43C371Medicare ID - Type Unspecified