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General NPI Number Information
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NPI Number | 1669365664
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Entity Type | Organization
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Legal Business Name | NEW YORK PAIN PUMP MEDICINE PC
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Dates
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Enumeration Date | 05/30/2025
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Last Update Date | 06/16/2025
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Provider Practice Location Address
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Address Line | 36 W 44TH ST STE 600B
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City | NEW YORK
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State | NY
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Zip | 10036-8112
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Country | US
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Telephone | 917-299-8256
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Fax | 646-661-3963
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Provider Business Mailing Address
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Address Line | 116 SANDFORD ST
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City | BROOKLYN
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State | NY
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Zip | 11205-2987
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Country | US
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Telephone | 917-299-8256
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Fax | 646-661-3963
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Authorized Official
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Title or Position | OWNER
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Name | SUELANE SOUSA DO OURO RODRIGUES
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Credential |
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Telephone | 917-299-8256
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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 |
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License Number State |
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