MEDICARE: ACUTE AND CHRONIC PAIN MANAGEMENT AND MEDICINE

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
1	207L00000X	Anesthesiology Physician
2	207LP2900X	Pain Medicine (Anesthesiology) Physician

General Provider Information

NPI Number	:	1518199264
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACUTE AND CHRONIC PAIN MANAGEMENT AND MEDICINE

Provider Business Mailing Address
First Line	:	731 JOHNSTON TER
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10309-3917
Country	:	US
Telephone Number	:	347-286-0741
Fax Number	:	718-228-9845

Provider Business Practice Location Address
First Line	:	11 RALPH PL STE 204
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10304-4405
Country	:	US
Telephone Number	:	347-286-0741
Fax Number	:	718-228-9845

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	AYMAN ROUSHDY FARAG
Credential	:	MD
Telephone Number	:	347-286-0741

Provider Enumeration Date	:	08/13/2009
Last Update Date	:	02/25/2026

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Directions to “ACUTE AND CHRONIC PAIN MANAGEMENT AND MEDICINE ” Practice Location

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