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Organization
EASTERN REGIONAL PAIN MGT
Active
Organization
EASTERN REGIONAL PAIN MGT
Active
Parent organization
EASTERN REGIONAL PAIN MANAGEMENT
Organization subpart
Yes
Provider details
NPI number
Legal business name
EASTERN REGIONAL PAIN MANAGEMENT
Authorized official
DR. THOMAS P COSTELLO DO (PAIN DOCTOR ANESTHESIOLOGY/PAIN MAN)
(215) 945-8882
Entity
Organization
Contact information
Practice address
151 FRIES MILL RD., TURNERSVILLE, NJ 08012
(215) 945-8882
(215) 945-9129
Mailing address
333. S. OXFORD VALLEY RD., STE 606, FAIRLESS HILLS, PA 19030
(215) 945-8882
(215) 945-9129
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
05005840L
PA
207LP2900X
Pain Medicine (Anesthesiology) Physician
MB50806
NJ
Other
Enumeration date
09/28/2010
Last updated
09/28/2010
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