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Organization

EASTERN REGIONAL PAIN MGT

Active
Parent organization
EASTERN REGIONAL PAIN MANAGEMENT
Organization subpart
Yes

Provider details

NPI number
Legal business name
EASTERN REGIONAL PAIN MANAGEMENT
Authorized official
DR. THOMAS P COSTELLO DO (PAIN DOCTOR ANESTHESIOLOGY/PAIN MAN)
(215) 945-8882
Entity
Organization

Contact information

Practice address
151 FRIES MILL RD., TURNERSVILLE, NJ 08012
(215) 945-8882
(215) 945-9129
Mailing address
333. S. OXFORD VALLEY RD., STE 606, FAIRLESS HILLS, PA 19030
(215) 945-8882
(215) 945-9129

Taxonomy

Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
05005840L
PA
207LP2900X
Pain Medicine (Anesthesiology) Physician
MB50806
NJ

Other

Enumeration date
09/28/2010
Last updated
09/28/2010
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