Organization
PAIN DIAGNOSTICS & INTERVENTIONAL CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID ANTHONY PROVENZANO MD (PRESIDENT)
(412) 860-4644
Entity
Organization
Contact information
Practice address
301 OHIO RIVER BLVD, SUITE 203, SEWICKLEY, PA 15143-1300
(412) 221-7640
(412) 490-9850
Mailing address
PO BOX 203, BRIDGEVILLE, PA 15017-0203
(412) 221-7640
(412) 490-9850
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
—
Other
Enumeration date
08/06/2013
Last updated
10/14/2013
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