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Organization

PROGRESSIVE PAIN MANAGEMENT LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. BRIAN ALWIN BANNISTER MD (CEO/MEMBER)
(347) 424-6157
Entity
Organization

Contact information

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

Taxonomy

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

Other

Enumeration date
11/04/2013
Last updated
01/08/2021
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