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General NPI Number Information
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NPI Number | 1477912822
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Entity Type | Organization
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Legal Business Name | RICHMOND INTERVENTIONAL PAIN MANAGEMENT PC
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Dates
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Enumeration Date | 02/14/2016
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Last Update Date | 02/16/2017
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Provider Practice Location Address
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Address Line | 2066 RICHMOND AVE STE 202
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City | STATEN ISLAND
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State | NY
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Zip | 10314-3961
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Country | US
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Telephone | 718-698-3900
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Fax | 855-564-5600
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Provider Business Mailing Address
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Address Line | 2066 RICHMOND AVE STE 202
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City | STATEN ISLAND
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State | NY
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Zip | 10314-3961
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Country | US
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Telephone | 718-698-3900
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Fax | 855-564-5600
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | MARIANNE DWYER
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Credential |
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Telephone | 718-698-3900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number |
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License Number State |
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