Provider Demographics
NPI:1104482850
Name:KEYSTONE PAIN CONSULTANTS & INTERVENTIONAL SPINE SPECIALISTS PC
Entity type:Organization
Organization Name:KEYSTONE PAIN CONSULTANTS & INTERVENTIONAL SPINE SPECIALISTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:BISIGNANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-866-7246
Mailing Address - Street 1:PO BOX 72098
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44192-0002
Mailing Address - Country:US
Mailing Address - Phone:412-866-7246
Mailing Address - Fax:412-866-7240
Practice Address - Street 1:80 LANDINGS DR STE 202
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-9408
Practice Address - Country:US
Practice Address - Phone:724-969-0191
Practice Address - Fax:724-941-9089
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-17
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMD043068LOtherSTATE LICENSE