Basic Information
| Provider Information | |||||||||
| NPI: | 1255863031 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PAIN MEDICINE OF YORK, LLC | ||||||||
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| OtherOrganizationName: | ALL BETTER WELLNESS CENTER | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1497A S QUEEN ST | ||||||||
| Address2: | |||||||||
| City: | YORK | ||||||||
| State: | PA | ||||||||
| PostalCode: | 174033852 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7178483979 | ||||||||
| FaxNumber: | 7176688967 | ||||||||
| Practice Location | |||||||||
| Address1: | 301 E. PLEASANT VALLEY BLVD. | ||||||||
| Address2: | |||||||||
| City: | ALTOONA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 16602 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8149445835 | ||||||||
| FaxNumber: | 8149449184 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/30/2017 | ||||||||
| LastUpdateDate: | 02/04/2019 | ||||||||
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| AuthorizedOfficialLastName: | MAYKO | ||||||||
| AuthorizedOfficialFirstName: | FLORENTINA | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 8144674055 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207LP2900X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine | 208VP0000X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pain Medicine | Pain Medicine | 208VP0014X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pain Medicine | Interventional Pain Medicine |
No ID Information.