Provider Demographics
NPI:1922423151
Name:ADVANCED PAIN & WELLNESS INSTITUTE, LLP
Entity Type:Organization
Organization Name:ADVANCED PAIN & WELLNESS INSTITUTE, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MIRIAM
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:SHAPIRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-250-7420
Mailing Address - Street 1:6245 SHERIDAN DR
Mailing Address - Street 2:SUITE 116
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-4834
Mailing Address - Country:US
Mailing Address - Phone:716-250-7420
Mailing Address - Fax:716-408-3201
Practice Address - Street 1:6245 SHERIDAN DR
Practice Address - Street 2:SUITE 116
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-4834
Practice Address - Country:US
Practice Address - Phone:716-250-7420
Practice Address - Fax:716-408-3201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-25
Last Update Date:2014-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY33D2009244291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory