Provider Demographics
NPI:1730192899
Name:PAIN RECOVERY SOLUTIONS, P.C.
Entity type:Organization
Organization Name:PAIN RECOVERY SOLUTIONS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HERBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:MALINOFF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:734-434-6600
Mailing Address - Street 1:4870 W CLARK RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48197-1104
Mailing Address - Country:US
Mailing Address - Phone:734-434-6600
Mailing Address - Fax:734-434-6684
Practice Address - Street 1:4870 W CLARK RD
Practice Address - Street 2:SUITE 201
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-1104
Practice Address - Country:US
Practice Address - Phone:734-434-6600
Practice Address - Fax:734-434-6684
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIMH82016207RA0401X, 208VP0000X
MICC048048207RA0401X, 207V00000X, 208VP0000X
MIPT0822072084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction MedicineGroup - Multi-Specialty
Not Answered207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Not Answered2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
Not Answered208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI=========OtherTAX ID
MI0P12840Medicare PIN