# PAIN TREATMENT CENTERS OF MARYLAND, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174917736
- **Authorized official:** TATYANA REZNIKOV MD (MBR)
- **Authorized official phone:** (410) 833-1101

## Contact information

- **Practice address:** 116 WESTMINSTER PIKE, SUITE 106, REISTERSTOWN, MD 21136-1027
- **Practice address phone:** (410) 833-1011
- **Practice address fax:** (410) 833-1680
- **Mailing address:** 116 WESTMINSTER PIKE, SUITE 106, REISTERSTOWN, MD 21136-1027
- **Mailing address phone:** (410) 833-1011
- **Mailing address fax:** (410) 833-1680

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | NULL | Yes |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/22/2015
- **Last updated:** 01/29/2016