Maryland Interventional Pain Management LLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

MARYLAND INTERVENTIONAL PAIN MANAGEMENT LLC

Practice address

5430 Campbell Blvd
Suite 106
White Marsh, MD 21162-5500

Phone

(443) 725-4930

NPI assigned

Dec 12, 2011

Last updated

Dec 12, 2011By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mary Martelloni

Title

Practice Adm

Phone

(865) 466-0650

Specialties & licenses 3

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1323648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323648000000",
    "number": "1356619803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5430 CAMPBELL BLVD",
            "address_2": "SUITE 106",
            "city": "WHITE MARSH",
            "state": "MD",
            "postal_code": "211625500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5430 CAMPBELL BLVD",
            "address_2": "SUITE 106",
            "city": "WHITE MARSH",
            "state": "MD",
            "postal_code": "211625500",
            "telephone_number": "443-725-4930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYLAND INTERVENTIONAL PAIN MANAGEMENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-12",
        "last_updated": "2011-12-12",
        "status": "A",
        "authorized_official_last_name": "MARTELLONI",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "PRACTICE ADM",
        "authorized_official_telephone_number": "865-466-0650"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marlene Malka Langer Young, MS,CNS
• Lansdowne Podiatry
• Michelle Lopez
• Lorraine Ofori-Awuah MD PA
• Robert Madison
• Maryland Interventional Pain Management, LLC (Baltimore Pain Relief Center)
• Jonathan Matz, M.D.
• Alicia Lajuan Medina, CRNP
• Megasource Providers Inc.
• Julien Mignon, DC

• Multi-Specialty Clinic/Center in White Marsh, MD
• Providers in White Marsh, MD by specialty
• Multi-Specialty Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.