Healthcare Provider Details

I. General information

NPI: 1184791899
Provider Name (Legal Business Name): PAIN DOCTOR MEDICAL PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 W 34TH ST PENTHOUSE SUITE
NEW YORK NY
10001-3006
US

IV. Provider business mailing address

PO BOX 1367
MORRISTOWN NJ
07962-1367
US

V. Phone/Fax

Practice location:
  • Phone: 212-877-3600
  • Fax:
Mailing address:
  • Phone: 973-989-2644
  • Fax: 973-989-2645

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number151413-1
License Number StateNY

VIII. Authorized Official

Name: DR. KENNETH ZAHL
Title or Position: DIRECTOR
Credential: M.D.
Phone: 212-877-6200