Organization
EASTERN STATES PAIN SPECIALISTS, LLC
Active
Parent organization
RA PAIN SERVICES, PA
Organization subpart
Yes
Provider details
NPI number
Legal business name
RA PAIN SERVICES, PA
Authorized official
JEFFREY GORDON M.D. (AUTHORIZED OFFICIAL)
(201) 667-5568
Entity
Organization
Contact information
Practice address
15000 MIDLANTIC DR, MOUNT LAUREL, NJ 08054-1573
(856) 855-5479
Mailing address
PO BOX 4604, LANCASTER, PA 17604-4604
(201) 804-2800
(201) 804-8883
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
—
—
Other
Enumeration date
10/07/2015
Last updated
10/07/2015
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