Eastern Regional Pain Management, P.C.

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

License

OS005840L Issued in PA

Legal business name

EASTERN REGIONAL PAIN MANAGEMENT, P.C.

Practice address

4979 Old Street Rd
Suite 1a
Trevose, PA 19053-6222

Phone

(215) 953-8882

Fax

(215) 953-8822

NPI assigned

Apr 26, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Thomas P Costello, DO

Title

President

Phone

(215) 953-8882

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Thomas P Costello DO Former legal business name

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329696000000",
    "number": "1922065986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4979 OLD STREET RD",
            "address_2": "SUITE A",
            "city": "TREVOSE",
            "state": "PA",
            "postal_code": "190536222",
            "telephone_number": "215-953-8882",
            "fax_number": "215-953-8822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4979 OLD STREET RD",
            "address_2": "SUITE 1A",
            "city": "TREVOSE",
            "state": "PA",
            "postal_code": "190536222",
            "telephone_number": "215-953-8882",
            "fax_number": "215-953-8822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN REGIONAL PAIN MANAGEMENT, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-26",
        "last_updated": "2012-02-20",
        "status": "A",
        "authorized_official_last_name": "COSTELLO",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "215-953-8882",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NJ",
            "license": "MB50806",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "PA",
            "license": "OS005840L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IBC",
            "identifier": "2006338000",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Thomas P Costello DO",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Vincent Paul Cullen, D.M.D.
• A Norman Dahl, PH.D.
• Abigail Heather Dalton, M.A., BCBA
• Kristina A Depinto
• Dr. Jeffrey S. Weisman, PC
• Encore Medical Staffing Northeast
• Esi Mail Pharmacy Service Inc
• William Phillip Fair, PHARM.
• Zachary Ficano
• Arnold David Fienman, DDS

• Pain Medicine (Anesthesiology) Physician in Trevose, PA
• Providers in Trevose, PA by specialty
• Pain Medicine (Anesthesiology) Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2012; 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.