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General NPI Number Information
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NPI Number | 1528673050
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Entity Type | Organization
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Legal Business Name | PAINRX INC
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Dates
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Enumeration Date | 09/11/2020
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Last Update Date | 09/11/2020
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Provider Practice Location Address
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Address Line | 29 STRATFORD N
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City | ROSLYN HEIGHTS
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State | NY
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Zip | 11577-2315
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Country | US
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Telephone | 718-877-6388
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Fax |
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Provider Business Mailing Address
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Address Line | 29 STRATFORD N
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City | ROSLYN HEIGHTS
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State | NY
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Zip | 11577-2315
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Country | US
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Telephone | 718-877-6388
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING SPECIALIST
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Name | DEREK MERCER
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Credential |
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Telephone | 718-877-6388
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number |
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License Number State |
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