Provider Demographics
NPI:1720251630
Name:BAY STATE PAIN ASSOCIATES PC
Entity Type:Organization
Organization Name:BAY STATE PAIN ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHERIF
Authorized Official - Middle Name:
Authorized Official - Last Name:ALGENDY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-582-5367
Mailing Address - Street 1:660 WASHINGTON ST
Mailing Address - Street 2:# 21E
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02111-3200
Mailing Address - Country:US
Mailing Address - Phone:516-582-5367
Mailing Address - Fax:857-277-0386
Practice Address - Street 1:22 PLEASANT ST
Practice Address - Street 2:SUITE 2N
Practice Address - City:WEST BRIDGEWATER
Practice Address - State:MA
Practice Address - Zip Code:02379-1506
Practice Address - Country:US
Practice Address - Phone:508-436-2555
Practice Address - Fax:508-436-2556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-11
Last Update Date:2015-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA223072207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty