Healthcare Provider Details

I. General information

NPI: 1033137708
Provider Name (Legal Business Name): PROFESSIONAL PAIN MANAGEMENT P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2735 HENRY HUDSON PARKWAY SUITE 202
BRONX NY
10463
US

IV. Provider business mailing address

4911 ARLINGTON AVE
BRONX NY
10471-2819
US

V. Phone/Fax

Practice location:
  • Phone: 718-796-1851
  • Fax: 201-796-4080
Mailing address:
  • Phone: 917-238-3871
  • Fax: 201-796-4080

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number138825
License Number StateNY

VIII. Authorized Official

Name: DR. NIRMAL PATEL
Title or Position: PRESIDENT
Credential: M.D.
Phone: 718-796-1851