Healthcare Provider Details

I. General information

NPI: 1871846683
Provider Name (Legal Business Name): INTEGRATED PAIN AND REHABILITATION SOLUTIONS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2012
Last Update Date: 06/13/2026
Certification Date: 06/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29 SYCAMORE LN
COMMACK NY
11725-2329
US

IV. Provider business mailing address

29 SYCAMORE LN
COMMACK NY
11725-2329
US

V. Phone/Fax

Practice location:
  • Phone: 201-907-5094
  • Fax: 347-620-3517
Mailing address:
  • Phone: 833-664-7246
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number216092
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code2081P0004X
TaxonomySpinal Cord Injury Medicine Physician
License Number216092
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number216092
License Number StateNY

VIII. Authorized Official

Name: NASAR M SHAHID
Title or Position: CEO / PRESIDENT
Credential: MD
Phone: 833-664-7246