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General NPI Number Information
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NPI Number | 1013215276
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Entity Type | Organization
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Legal Business Name | INJURY PAIN RELIEF MEDICAL PC
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Dates
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Enumeration Date | 03/11/2011
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Last Update Date | 03/11/2011
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Provider Practice Location Address
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Address Line | 101 CASTLETON ST
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City | PLEASANTVILLE
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State | NY
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Zip | 10570-3400
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Country | US
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Telephone | 855-887-3422
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Fax |
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Provider Business Mailing Address
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Address Line | 101 CASTLETON ST
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City | PLEASANTVILLE
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State | NY
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Zip | 10570-3400
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | VINCENT CARLESI
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Credential |
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Telephone | 855-887-3422
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number | 189623-1
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License Number State | NY
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