NPIMap

Organization Active NPI

Eastern States Pain Specialists Limited

  • Interventional Pain Medicine Physician
  • Mount Laurel, NJ
National Provider Identifier
1477937670
Registry record updated Jul 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
25MA08897600 Issued in NJ
Legal business name
EASTERN STATES PAIN SPECIALISTS LIMITED
Practice address
15000 Midlantic Dr Ste 102
Mount Laurel, NJ 08054-1573
Phone
(856) 255-5479
Fax
(856) 393-8481
NPI assigned
Jul 17, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2015

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

Authorized official

Name
Dr. Scott Pello, M.D.
Title
Managing Partner
Phone
(856) 255-5479

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208VP0014X 25MA08897600 NJ Primary

Addresses

Primary practice location

15000 Midlantic Dr Ste 102
Mount Laurel, NJ 08054-1573

Mailing address

15000 Midlantic Dr Ste 102
Mount Laurel, NJ 08054-1573
Phone (856) 255-5479

National Provider Directory

National Provider Directory
Tax ID family
Eastern States Pain Specialists Limited2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1437091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437091200000",
    "number": "1477937670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15000 MIDLANTIC DR STE 102",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080541573",
            "telephone_number": "856-255-5479",
            "fax_number": "856-393-8481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15000 MIDLANTIC DR STE 102",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080541573",
            "telephone_number": "856-255-5479",
            "fax_number": "856-393-8481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN STATES PAIN SPECIALISTS LIMITED",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-17",
        "last_updated": "2015-07-17",
        "status": "A",
        "authorized_official_last_name": "PELLO",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "856-255-5479",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NJ",
            "license": "25MA08897600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Laurel, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2015; 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.