Healthcare Provider Details

I. General information

NPI: 1023542008
Provider Name (Legal Business Name): BRIAN MAYRSOHN M.D., M.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2017
Last Update Date: 07/16/2025
Certification Date: 07/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

146A MANETTO HILL RD STE 100
PLAINVIEW NY
11803-1323
US

IV. Provider business mailing address

146A MANETTO HILL RD STE 100
PLAINVIEW NY
11803-1323
US

V. Phone/Fax

Practice location:
  • Phone: 516-523-1506
  • Fax:
Mailing address:
  • Phone: 516-200-4814
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number317458
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number317458
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number317458-01
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: