Unknown Individual – Pain Medicine (Anesthesiology) Physician, NPI 1639166572
Excluded from federal healthcare programs (Medicare/Medicaid)
This provider is listed on the OIG List of Excluded Individuals/Entities (LEIE). Exclusion effective: 2020-12-20. Reason: License revocation, suspension, or surrender.
Pain Medicine (Anesthesiology) Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
Chapel Street, East Ferry, Newark, Essex County, New Jersey, 07105, United States
SUITE 100 ANESTHESIOLOGY AND PAIN MANAGEMENT
NEWARK, DE 19702
Phone: (302) 235-8074
Fax: (302) 235-8140
Type: Mailing
2800, Lancaster Avenue, Greenhill, Wawaset Park, Wilmington, New Castle County, Delaware, 19805, United States
SUITE 6
WILMINGTON, DE 198052329
Phone: (623) 551-8441
Fax: (623) 388-4825
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 19702)
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