| Valley Pain Relief And Wellness Center, Pllc | |
|
2428 E 117th St Burnsville MN 55337-1269 | |
| (612) 444-3000 | |
| Not Available |
| Full Name | Valley Pain Relief And Wellness Center, Pllc |
|---|---|
| Speciality | Psychologist |
| Location | 2428 E 117th St, Burnsville, Minnesota |
| Authorized Official Name and Position | Ashwin Vinod George (VP, CEO) |
| Authorized Official Contact | 6124443000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Valley Pain Relief And Wellness Center, Pllc 2428 E 117th St Burnsville MN 55337-1269 Ph: (612) 444-3000 | Valley Pain Relief And Wellness Center, Pllc 2428 E 117th St Burnsville MN 55337-1269 Ph: (612) 444-3000 |
| NPI Number | 1851922819 |
|---|---|
| Provider Enumeration Date | 01/29/2020 |
| Last Update Date | 02/28/2020 |
| Certification Date | 02/28/2020 |
| Medicare PECOS PAC ID | 7517198211 |
|---|---|
| Medicare Enrollment ID | O20140321001462 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851922819 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Secondary |
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| Provider Name | Ashwin V George |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1518169713 PECOS PAC ID: 5698862415 Enrollment ID: I20071025000672 |
| Provider Name | Suzanne K Obrien |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295929263 PECOS PAC ID: 9537254370 Enrollment ID: I20080617000209 |
| Provider Name | Svetlana Zaydman |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1285960013 PECOS PAC ID: 5294864377 Enrollment ID: I20110921000308 |
| Provider Name | Mary S Paul |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659753697 PECOS PAC ID: 9739495359 Enrollment ID: I20150827001651 |
| Provider Name | Sivilai Vang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790327781 PECOS PAC ID: 3577994276 Enrollment ID: I20200513001770 |
| Provider Name | Lenore I Everson |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1407106149 PECOS PAC ID: 4880086875 Enrollment ID: I20220125002446 |
| Provider Name | Lauren M Holzfaster |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902593791 PECOS PAC ID: 4183080286 Enrollment ID: I20230516000931 |
| Provider Name | Amy C Patella |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1053541987 PECOS PAC ID: 5698815397 Enrollment ID: I20230801003174 |
| Provider Name | Rajesh Kannan Ethiraj |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1669667242 PECOS PAC ID: 4082878590 Enrollment ID: I20240606001738 |
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