Provider Demographics
NPI:1386102614
Name:PREMIER PAIN MANAGEMENT PLLC
Entity type:Organization
Organization Name:PREMIER PAIN MANAGEMENT PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:OMAR
Authorized Official - Middle Name:RASHID
Authorized Official - Last Name:QURESHI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:978-343-7246
Mailing Address - Street 1:33 ELECTRIC AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:FITCHBURG
Mailing Address - State:MA
Mailing Address - Zip Code:01420-7954
Mailing Address - Country:US
Mailing Address - Phone:978-343-7246
Mailing Address - Fax:978-343-7247
Practice Address - Street 1:33 ELECTRIC AVE STE 102
Practice Address - Street 2:
Practice Address - City:FITCHBURG
Practice Address - State:MA
Practice Address - Zip Code:01420-7954
Practice Address - Country:US
Practice Address - Phone:978-343-7246
Practice Address - Fax:978-343-7247
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-05
Last Update Date:2022-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110075272AMedicaid