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General NPI Number Information
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NPI Number | 1922392588
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Entity Type | Organization
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Legal Business Name | PAIN PHYSICIANS ASSOCIATES, PLLC
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Dates
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Enumeration Date | 06/01/2011
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Last Update Date | 11/14/2013
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Provider Practice Location Address
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Address Line | 370 BAY RIDGE PKWY FIRST FLOOR
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City | BROOKLYN
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State | NY
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Zip | 11209-3176
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Country | US
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Telephone | 718-833-4800
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Fax | 718-833-0033
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Provider Business Mailing Address
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Address Line | 116 SANFORD STREET
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City | BROOKLYN
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State | NY
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Zip | 11205
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Country | US
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Telephone | 718-302-1111
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Fax | 718-506-9702
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. MEHRDAD HEDAYATNIA
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Credential | MD
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Telephone | 718-833-4800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | 251932
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License Number State | NY
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