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NPI Code Detail

MEDICARE: SPINE AND PAIN CONSULTANT, PLLC

MEDICARE: SPINE AND PAIN CONSULTANT, PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207LP2900XPain Medicine (Anesthesiology) Physician

General Provider Information

NPI Number : 1407569338
Entity Type Code : Organization
Provider Name (Legal Business Name) : SPINE AND PAIN CONSULTANT, PLLC
Provider Business Mailing Address
First Line : 1360 HYLAN BLVD
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10305-1922
Country : US
Telephone Number : 718-667-3577
Fax Number :
Provider Business Practice Location Address
First Line : 2932 WILKINSON AVE FL 4
Second Line :
City : BRONX
State : NY
Zip : 10461-4004
Country : US
Telephone Number : 718-667-3577
Fax Number :
Authorized Official
Title or Position : MEDICAL DIRECTOR
Name : KENNETH B CHAPMAN
Credential :
Telephone Number : 718-667-3577
Provider Enumeration Date : 01/05/2023
Last Update Date : 01/27/2023

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Directions to “SPINE AND PAIN CONSULTANT, PLLC ” Practice Location

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