Healthcare Provider Details

I. General information

NPI: 1437888971
Provider Name (Legal Business Name): SECKIN PAIN MANAGEMENT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2022
Last Update Date: 06/09/2022
Certification Date: 06/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 PROSPECT AVE SUITE 602
HACKENSACK NY
10960-1096
US

IV. Provider business mailing address

2 TOMPKINS CT
NYACK NY
10960-1225
US

V. Phone/Fax

Practice location:
  • Phone: 201-809-3000
  • Fax: 201-809-3300
Mailing address:
  • Phone: 201-780-1511
  • Fax: 201-809-3300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP3300X
TaxonomyPain Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. ALI INANC SECKIN
Title or Position: OWNER
Credential: MD MBA
Phone: 201-780-1511