Organization
VITAL PAIN CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JORGE NELSON RIVERO BECERRA M.D. (OWNER)
(917) 595-9244
Entity
Organization
Contact information
Practice address
363 VANADIUM RD, SUITE 106, PITTSBURGH, PA 15243-1497
(412) 279-1231
(412) 276-0935
Mailing address
363 VANADIUM RD, SUITE 106, PITTSBURGH, PA 15243-1497
(412) 279-1231
(412) 276-0935
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
MD441214
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1027556710001
—
PA
Enumeration date
12/21/2015
Last updated
12/21/2015
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