Provider Demographics
NPI:1790967990
Name:PAIN CONTROL CENTER OF PITTSBURGH INC
Entity Type:Organization
Organization Name:PAIN CONTROL CENTER OF PITTSBURGH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GERARD
Authorized Official - Middle Name:A
Authorized Official - Last Name:MYERS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:724-728-7880
Mailing Address - Street 1:3627 BRODHEAD RD
Mailing Address - Street 2:
Mailing Address - City:MONACA
Mailing Address - State:PA
Mailing Address - Zip Code:15061-2681
Mailing Address - Country:US
Mailing Address - Phone:724-728-7880
Mailing Address - Fax:724-728-7881
Practice Address - Street 1:3627 BRODHEAD RD
Practice Address - Street 2:
Practice Address - City:MONACA
Practice Address - State:PA
Practice Address - Zip Code:15061-2681
Practice Address - Country:US
Practice Address - Phone:724-728-7880
Practice Address - Fax:724-728-7881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-29
Last Update Date:2010-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
001518564OtherBLUE CROSS
2534690OtherAETNA
2534690OtherAETNA