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General NPI Number Information
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NPI Number | 1124193883
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Entity Type | Organization
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Legal Business Name | PHYSICIAN PAIN TREATMENT ASSOCIATES, PC
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Dates
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Enumeration Date | 11/21/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 132 ATLANTIC AVE
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City | BROOKLYN
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State | NY
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Zip | 11201-5502
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Country | US
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Telephone | 718-935-9666
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Fax | 718-935-9667
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Provider Business Mailing Address
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Address Line | 132 ATLANTIC AVE
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City | BROOKLYN
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State | NY
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Zip | 11201-5502
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Country | US
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Telephone | 718-935-9666
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Fax | 718-935-9667
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. ALEXANDER MAUSKOP
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Credential | MD
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Telephone | 212-794-3550
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 208981
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License Number State | NY
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