Organization
FLOURTOWN PAIN EVALUATION AND TREATMENT CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH L IZZO MD (MEDICAL DIRECTOR)
(215) 233-1223
Entity
Organization
Contact information
Practice address
1811 BETHLEHEM PIKE, SUITE 221, FLOURTOWN, PA 19031
(215) 233-1223
(215) 233-1141
Mailing address
1811 BETHLEHEM PIKE, SUITE 221, FLOURTOWN, PA 19031
(215) 233-1223
(215) 233-1141
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
MD017101
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0060080000
BCBS KEYSTONE EAST
—
05
—
01927385
—
PA
01
—
12112248
VA MEDICARE
PA
01
—
3503051
AETNA HEALTHCARE
PA
Enumeration date
11/14/2006
Last updated
08/22/2020
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