Provider Demographics
NPI:1952389926
Name:YORK PAIN CONSULTANTS LLC PA
Entity Type:Organization
Organization Name:YORK PAIN CONSULTANTS LLC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:J
Authorized Official - Last Name:DELORIE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:207-363-4114
Mailing Address - Street 1:519 US ROUTE 1
Mailing Address - Street 2:UNIT 9
Mailing Address - City:YORK
Mailing Address - State:ME
Mailing Address - Zip Code:03909
Mailing Address - Country:US
Mailing Address - Phone:207-363-4114
Mailing Address - Fax:207-363-4126
Practice Address - Street 1:519 US ROUTE 1
Practice Address - Street 2:UNIT 9 YORK PAIN COSULTANTS LLC PA
Practice Address - City:YORK
Practice Address - State:ME
Practice Address - Zip Code:03909
Practice Address - Country:US
Practice Address - Phone:207-363-4114
Practice Address - Fax:207-363-4126
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-09
Last Update Date:2012-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME1853208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME048142OtherANTHEM
ME048142OtherANTHEM
MEME1357Medicare PIN