# PAIN DIAGNOSTICS & INTERVENTIONAL CARE LLC

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

## Provider details

- **NPI number:** 1548692031
- **Authorized official:** DR. DAVID ANTHONY PROVENZANO MD (PRESIDENT)
- **Authorized official phone:** (412) 860-4644

## Contact information

- **Practice address:** 301 OHIO RIVER BLVD, SUITE 203, SEWICKLEY, PA 15143-1300
- **Practice address phone:** (412) 221-7640
- **Practice address fax:** (412) 490-9850
- **Mailing address:** PO BOX 203, BRIDGEVILLE, PA 15017-0203
- **Mailing address phone:** (412) 221-7640
- **Mailing address fax:** (412) 490-9850

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | NULL | Yes |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/06/2013
- **Last updated:** 10/14/2013