Healthcare Provider Details

I. General information

NPI: 1730350547
Provider Name (Legal Business Name): MINSHENG PAIN MANAGEMENT & ANESTHESIA, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2008
Last Update Date: 08/13/2024
Certification Date: 08/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3916 PRINCE ST STE 353
FLUSHING NY
11354-5367
US

IV. Provider business mailing address

3916 PRINCE ST STE 353
FLUSHING NY
11354-5367
US

V. Phone/Fax

Practice location:
  • Phone: 718-321-8066
  • Fax: 718-559-6965
Mailing address:
  • Phone: 718-321-8066
  • Fax: 718-559-6965

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number223423
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207LA0401X
TaxonomyAddiction Medicine (Anesthesiology) Physician
License Number223423
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number223423
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number223423
License Number StateNY

VIII. Authorized Official

Name: CHUN MING CHEN
Title or Position: OWNER
Credential: MD
Phone: 718-321-8066