# EASTERN STATES PAIN SPECIALISTS, LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Parent organization:** RA PAIN SERVICES, PA
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1225409980
- **Legal business name:** RA PAIN SERVICES, PA
- **Authorized official:** JEFFREY GORDON M.D. (AUTHORIZED OFFICIAL)
- **Authorized official phone:** (201) 667-5568

## Contact information

- **Practice address:** 15000 MIDLANTIC DR, MOUNT LAUREL, NJ 08054-1573
- **Practice address phone:** (856) 855-5479
- **Mailing address:** PO BOX 4604, LANCASTER, PA 17604-4604
- **Mailing address phone:** (201) 804-2800
- **Mailing address fax:** (201) 804-8883

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208VP0000X | Pain Medicine Physician | — | NULL | Yes |
| 208VP0000X | Pain Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/07/2015
- **Last updated:** 10/07/2015