Healthcare Provider Details

I. General information

NPI: 1174661722
Provider Name (Legal Business Name): COMPREHENSIVE PAIN MANAGEMENT-ANESTHESIA SERVICES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2007
Last Update Date: 02/16/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 MAIDEN LN SUITE 1206
NEW YORK NY
10038-4810
US

IV. Provider business mailing address

75 MAIDEN LN RM 1206
NEW YORK NY
10038-4810
US

V. Phone/Fax

Practice location:
  • Phone: 212-995-6495
  • Fax: 212-844-6772
Mailing address:
  • Phone: 646-602-8030
  • Fax: 646-602-9154

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207LA0401X
TaxonomyAddiction Medicine (Anesthesiology) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code207LH0002X
TaxonomyHospice and Palliative Medicine (Anesthesiology) Physician
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. GARY PAUL THOMAS
Title or Position: PRESIDENT
Credential: M.D.
Phone: 646-602-8030