Provider Demographics
NPI:1700233905
Name:RA PAIN SERVICES PA
Entity Type:Organization
Organization Name:RA PAIN SERVICES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:BURHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HALEEM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:855-727-2465
Mailing Address - Street 1:110 HARBOR LN
Mailing Address - Street 2:SUITE A
Mailing Address - City:SOMERS POINT
Mailing Address - State:NJ
Mailing Address - Zip Code:08244-2470
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1801 NEW RD
Practice Address - Street 2:
Practice Address - City:LINWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08221-1036
Practice Address - Country:US
Practice Address - Phone:609-703-5097
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:R.A.PAIN SERVICES, P.A.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-05-17
Last Update Date:2021-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty