Provider Demographics
NPI:1932518669
Name:PHARO PAIN MANAGEMENT ASOCIATES, P.C.
Entity Type:Organization
Organization Name:PHARO PAIN MANAGEMENT ASOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:HERBERT
Authorized Official - Last Name:PHARO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:215-925-0986
Mailing Address - Street 1:119 DEERFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-7103
Mailing Address - Country:US
Mailing Address - Phone:856-767-8075
Mailing Address - Fax:
Practice Address - Street 1:829 SPRUCE ST STE 308
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-5752
Practice Address - Country:US
Practice Address - Phone:215-925-0986
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-06
Last Update Date:2014-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS-006962E207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty