Provider Demographics
NPI:1902147739
Name:MID ATLANTIC PAIN INSTITUTE
Entity Type:Organization
Organization Name:MID ATLANTIC PAIN INSTITUTE
Other - Org Name:MID ATLANTIC SPINE AND PAIN PHYSICIANS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:FALCO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:443-303-8987
Mailing Address - Street 1:100 BIDDLE AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-3981
Mailing Address - Country:US
Mailing Address - Phone:302-369-1700
Mailing Address - Fax:302-369-1717
Practice Address - Street 1:550 S DUPONT BLVD
Practice Address - Street 2:SOUTH DUPONT PLAZA, SUITE A
Practice Address - City:MILFORD
Practice Address - State:DE
Practice Address - Zip Code:19963
Practice Address - Country:US
Practice Address - Phone:302-725-6020
Practice Address - Fax:302-725-6021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-04
Last Update Date:2018-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE2081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Single Specialty