Provider Demographics
NPI:1104980770
Name:MID-ATLANTIC PAIN INSTITUTE, P.A.
Entity type:Organization
Organization Name:MID-ATLANTIC PAIN INSTITUTE, P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:FALCO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:302-369-1700
Mailing Address - Street 1:139 E CHESTNUT HILL RD
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-4043
Mailing Address - Country:US
Mailing Address - Phone:302-369-1700
Mailing Address - Fax:302-369-1717
Practice Address - Street 1:1806 N VAN BUREN ST
Practice Address - Street 2:SUITE 110
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19802-3851
Practice Address - Country:US
Practice Address - Phone:302-472-0163
Practice Address - Fax:302-472-0164
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-20
Last Update Date:2009-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC10004539208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE001097202Medicaid
DECF8249OtherRAILROAD MEDICARE
DEG00428Medicare PIN
DECF8249OtherRAILROAD MEDICARE