PA Green Wellness

Primary specialty

Pain Clinic/CenterTaxonomy code 261QP3300X

Legal business name

PA GREEN WELLNESS

Practice address

1150 First Ave Ste 950
King of Prussia, PA 19406-1371

Phone

(610) 909-2207

Fax

(888) 371-6433

NPI assigned

Jul 10, 2020

Organization subpart

No

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

Authorized official

Name

John Cellini

Title

President

Phone

(610) 909-2207

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1594339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595289600000",
    "number": "1679191142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 FIRST AVE STE 950",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194061371",
            "telephone_number": "610-909-2207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 FIRST AVE STE 950",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194061371",
            "telephone_number": "610-909-2207",
            "fax_number": "888-371-6433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PA GREEN WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-10",
        "last_updated": "2020-07-21",
        "certification_date": "2020-07-21",
        "status": "A",
        "authorized_official_last_name": "CELLINI",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "610-909-2207"
    },
    "taxonomies": [
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Arthur Lee Osterman Jr., M.D.
• Meredith N Osterman, M.D.
• Victoria Lief Ostroff, PSY.D.
• Otto Bock Patient Care, LLC
• Our Shared Path Counseling
• James W Padget III, MD
• Sonia M Padget, MD
• Joanna Lynn Palac, CRNP
• Madhavilatha Palamoor, MD, MBBS
• Stephen Palish, PHARMD

• Pain Clinic/Center in King of Prussia, PA
• Providers in King of Prussia, PA by specialty
• Pain Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2020; 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.