Provider Demographics
NPI:1194960427
Name:PAIN MANAGEMENT PHYSICIANS, LLC
Entity type:Organization
Organization Name:PAIN MANAGEMENT PHYSICIANS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:RATNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-375-6226
Mailing Address - Street 1:PO BOX 45749
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21297-5749
Mailing Address - Country:US
Mailing Address - Phone:215-338-1811
Mailing Address - Fax:215-338-3606
Practice Address - Street 1:2201 RIDGEWOOD RD STE 200
Practice Address - Street 2:
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-1196
Practice Address - Country:US
Practice Address - Phone:610-375-6226
Practice Address - Fax:484-509-2933
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-16
Last Update Date:2022-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA613887100OtherDEPARTMENT OF LABOR
PA9287272OtherAETNA
PA2088002OtherHIGHMARK BLUE SHIELD
PA3688587000OtherINDEPENDENCE BLUE CROSS
PA=========OtherCIGNA
PA2088002OtherHIGHMARK BLUE SHIELD
PA=========OtherDEVON
PA9287272OtherAETNA