Organization
CENTRAL PENN INTERVENTIONAL PAIN MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHIYI ABLA-YAO M.D. (OWNER)
(570) 490-1498
Entity
Organization
Contact information
Practice address
451 RIVER AVE, WILLIAMSPORT, PA 17701-3722
(570) 490-1498
Mailing address
PO BOX 99, WINFIELD, PA 17889-0099
(570) 490-1498
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
MD057849L
PA
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
MD057849L
PA
208VP0014X
Interventional Pain Medicine Physician
MD057849L
PA
Other
Enumeration date
03/17/2008
Last updated
03/20/2014
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