# PROGRESSIVE PAIN MANAGEMENT LLC

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

## Provider details

- **NPI number:** 1326477985
- **Authorized official:** DR. BRIAN ALWIN BANNISTER MD (CEO/MEMBER)
- **Authorized official phone:** (347) 424-6157

## Contact information

- **Practice address:** 802 W PARK AVE STE 223, OCEAN, NJ 07712-8526
- **Practice address phone:** (732) 493-2040
- **Practice address fax:** (732) 493-4582
- **Mailing address:** 802 W PARK AVE STE 223, OCEAN, NJ 07712-8526
- **Mailing address phone:** (732) 493-2040
- **Mailing address fax:** (732) 493-4582

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | 25MA08847600 | NJ | Yes |

## Other

- **Enumeration date:** 11/04/2013
- **Last updated:** 01/08/2021