Provider Demographics
NPI:1134606544
Name:TRIANGLE PAIN CONSULTANTS
Entity type:Organization
Organization Name:TRIANGLE PAIN CONSULTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:AYSEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ATLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-322-2064
Mailing Address - Street 1:8300 HEALTH PARK STE 109
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-4731
Mailing Address - Country:US
Mailing Address - Phone:919-322-2064
Mailing Address - Fax:919-322-2153
Practice Address - Street 1:8300 HEALTH PARK STE 109
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-4731
Practice Address - Country:US
Practice Address - Phone:612-999-7759
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-27
Last Update Date:2022-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1912084617Medicaid
NCNN1377AOtherMEDICARE