Healthcare Provider Details

I. General information

NPI: 1124995915
Provider Name (Legal Business Name): VORA PAIN MEDICINE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2025
Last Update Date: 10/17/2025
Certification Date: 10/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

138 LINDENWOOD RD
STATEN ISLAND NY
10308-2742
US

IV. Provider business mailing address

138 LINDENWOOD RD
STATEN ISLAND NY
10308-2742
US

V. Phone/Fax

Practice location:
  • Phone: 718-496-9550
  • Fax:
Mailing address:
  • Phone: 718-496-9550
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. KETAN D VORA
Title or Position: PRESIDENT
Credential:
Phone: 718-496-9550