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General NPI Number Information
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NPI Number | 1205222478
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Entity Type | Organization
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Legal Business Name | METROPOLITAN PAIN MEDICINE, PLLC
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Dates
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Enumeration Date | 04/14/2015
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Last Update Date | 04/15/2015
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Provider Practice Location Address
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Address Line | 162 E 78TH ST 2ND FLOOR
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City | NEW YORK
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State | NY
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Zip | 10075-0406
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Country | US
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Telephone | 631-629-4770
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Fax | 631-629-4772
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Provider Business Mailing Address
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Address Line | PO BOX 4168
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City | HUNTINGTON
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State | NY
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Zip | 11743-0779
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Country | US
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Telephone | 646-556-8980
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Fax | 631-629-4772
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | MR. NOLAN D TZOU
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Credential | M.D.
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Telephone | 631-629-4440
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number | A186571-1
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License Number State | NY
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