OrganizationActive
Eastern States Pain Specialists, LLC
NPI 1225409980 · Pain Medicine Physician · Mount Laurel, NJ
Provider details
- NPI number
- 1225409980
- Entity type
- Organization
- Primary specialty
- Pain Medicine PhysicianAllopathic & Osteopathic Physicians
- Parent organization
- Ra Pain Services, PA
- Organization subpart
- Yes
- Authorized official
- Jeffrey Gordon, Authorized Official(201) 667-5568
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
15000 Midlantic Dr
Mount Laurel, NJ 08054-1573
Phone: (856) 855-5479
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 4604
Lancaster, PA 17604-4604
Registry dates
- Enumerated
- 2015-10-07
- Last updated
- 2015-10-07
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.