Organization
INSTITUTE FOR PAIN RELIEF PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KAVITA GUPTA DO (OWNER)
(856) 751-7799
Entity
Organization
Contact information
Practice address
2309 E EVESHAM RD, SUITE B,C,D, VOORHEES, NJ 08043-1559
(856) 751-7799
Mailing address
33 FRANKLIN DR, VOORHEES, NJ 08043-2163
(856) 344-2788
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
#25MB07408300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0021466
—
NJ
01
—
075851C60
MEDICARE ID
NJ
Enumeration date
10/03/2007
Last updated
08/08/2008
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