Healthcare Provider Details

I. General information

NPI: 1154240752
Provider Name (Legal Business Name): CHABLA PAIN & PERFORMANCE MEDICINE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

133 E 58TH ST STE 714
NEW YORK NY
10022-1129
US

IV. Provider business mailing address

101 W 55TH ST APT 10D
NEW YORK NY
10019-5349
US

V. Phone/Fax

Practice location:
  • Phone: 516-439-8304
  • Fax:
Mailing address:
  • Phone: 516-439-8304
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. LUIS F CHABLA-PENAFIEL
Title or Position: OWNER
Credential: MD
Phone: 516-439-8304