Provider Demographics
NPI:1841256302
Name:NEW ENGLAND PAIN CARE
Entity type:Organization
Organization Name:NEW ENGLAND PAIN CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIEN
Authorized Official - Middle Name:
Authorized Official - Last Name:VAISMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:978-826-7234
Mailing Address - Street 1:PO BOX 223
Mailing Address - Street 2:
Mailing Address - City:SWAMPSCOTT
Mailing Address - State:MA
Mailing Address - Zip Code:01907-0323
Mailing Address - Country:US
Mailing Address - Phone:978-826-7234
Mailing Address - Fax:978-826-7239
Practice Address - Street 1:10 CENTENNIAL DR
Practice Address - Street 2:EAST ENTRANCE
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960-7900
Practice Address - Country:US
Practice Address - Phone:978-826-7234
Practice Address - Fax:978-826-7239
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-25
Last Update Date:2008-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA71164261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAM88028OtherBCBS
MA696732OtherTUFTS
MAM88028OtherBCBS