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General NPI Number Information
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NPI Number | 1457537227
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Entity Type | Organization
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Legal Business Name | NEW YORK ADVANCED SURGICAL INTERVENTION CARE, PLLC
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Dates
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Enumeration Date | 01/11/2008
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Last Update Date | 05/01/2025
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Provider Practice Location Address
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Address Line | 1250 WATERS PL STE 710
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City | BRONX
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State | NY
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Zip | 10461-2733
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Country | US
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Telephone | 718-794-0600
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Fax | 718-684-5728
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Provider Business Mailing Address
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Address Line | 1250 WATERS PL STE 710
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City | BRONX
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State | NY
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Zip | 10461-2733
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Country | US
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Telephone | 718-794-0600
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Fax | 718-684-5728
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Authorized Official
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Title or Position | OWNER
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Name | SIREEN GOPAL
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Credential | MD
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Telephone | 718-794-0600
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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 | 201895
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License Number State | NY
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