Provider Demographics
NPI: | 1821865569 |
---|---|
Name: | INTERVENTIONAL PAIN ASSOCIATES OF MASSACHUSETTS PLLC |
Entity Type: | Organization |
Organization Name: | INTERVENTIONAL PAIN ASSOCIATES OF MASSACHUSETTS PLLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | ANTHONY |
Authorized Official - Middle Name: | P |
Authorized Official - Last Name: | LOMONACO |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | DO |
Authorized Official - Phone: | 215-510-0505 |
Mailing Address - Street 1: | 690 BAY RD |
Mailing Address - Street 2: | |
Mailing Address - City: | S HAMILTON |
Mailing Address - State: | MA |
Mailing Address - Zip Code: | 01982-1012 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 215-510-0505 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 900 CUMMINGS CTR STE 221U |
Practice Address - Street 2: | |
Practice Address - City: | BEVERLY |
Practice Address - State: | MA |
Practice Address - Zip Code: | 01915-6183 |
Practice Address - Country: | US |
Practice Address - Phone: | 351-400-6272 |
Practice Address - Fax: | 351-354-0070 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2023-12-04 |
Last Update Date: | 2023-12-04 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207LP2900X | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine | Group - Single Specialty |