Provider Demographics
NPI:1154529584
Name:BERESH PAIN MANAGEMENT
Entity type:Organization
Organization Name:BERESH PAIN MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:E
Authorized Official - Last Name:BERESH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-737-7246
Mailing Address - Street 1:840 NW WASHINGTON BLVD STE C
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45013-6381
Mailing Address - Country:US
Mailing Address - Phone:513-737-7246
Mailing Address - Fax:513-737-6601
Practice Address - Street 1:840 NW WASHINGTON BLVD STE C
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45013-6381
Practice Address - Country:US
Practice Address - Phone:513-737-7246
Practice Address - Fax:513-737-6601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-06
Last Update Date:2018-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH086579207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty