# EASTERN REGIONAL PAIN MGT

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** EASTERN REGIONAL PAIN MANAGEMENT
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1891004685
- **Legal business name:** EASTERN REGIONAL PAIN MANAGEMENT
- **Authorized official:** DR. THOMAS P COSTELLO DO (PAIN DOCTOR ANESTHESIOLOGY/PAIN MAN)
- **Authorized official phone:** (215) 945-8882

## Contact information

- **Practice address:** 151 FRIES MILL RD., TURNERSVILLE, NJ 08012
- **Practice address phone:** (215) 945-8882
- **Practice address fax:** (215) 945-9129
- **Mailing address:** 333. S. OXFORD VALLEY RD., STE 606, FAIRLESS HILLS, PA 19030
- **Mailing address phone:** (215) 945-8882
- **Mailing address fax:** (215) 945-9129

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | 05005840L | PA | Yes |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | MB50806 | NJ | — |

## Other

- **Enumeration date:** 09/28/2010
- **Last updated:** 09/28/2010