Organization
SUSSEX PAIN RELIEF CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MANONMANI ANTONY MD (OWNER)
(302) 519-0100
Entity
Organization
Contact information
Practice address
18229 DUPONT BLVD, GEORGETOWN, DE 19947
(302) 519-1616
(302) 253-8028
Mailing address
18229 DUPONT BLVD, GEORGETOWN, DE 19947-3127
(302) 514-7246
(302) 253-8028
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
DE
208100000X
Physical Medicine & Rehabilitation Physician
—
DE
208VP0000X
Pain Medicine Physician
Primary
—
DE
208VP0014X
Interventional Pain Medicine Physician
—
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1578886180
—
DE
Enumeration date
03/10/2010
Last updated
10/11/2018
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