Organization
GREATER PHILADELPHIA PAIN MANAGEMENT CENTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN M BAYZICK (COO)
(215) 957-5400
Entity
Organization
Contact information
Practice address
2612 RHAWN STREET, PHILADELPHIA, PA 19152
(215) 338-8555
(215) 957-5401
Mailing address
600 LOUIS DRIVE SUITE 202, GREATER PHILADELPHIA PAIN MANAGEMENT CENTER PC, WARMINSTER, PA 18974
(215) 957-5400
(215) 957-5401
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
MD425455
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0872975000
KEYSTONE/PC
PA
01
—
950467
HIGHMARK
PA
Enumeration date
10/12/2010
Last updated
06/10/2022
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