MEDICARE: APPLE PAIN MANGEMENT 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
1	207L00000X	Anesthesiology Physician
2	208VP0000X	Pain Medicine Physician

General Provider Information

NPI Number	:	1609258524
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	APPLE PAIN MANGEMENT PLLC

Provider Business Mailing Address
First Line	:	1475 ROYCE ST
Second Line	:	APT 2C
City	:	BROOKLYN
State	:	NY
Zip	:	11234-5932
Country	:	US
Telephone Number	:	718-758-5220
Fax Number	:	718-333-1398

Provider Business Practice Location Address
First Line	:	5607 AVENUE L
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-3317
Country	:	US
Telephone Number	:	718-758-5220
Fax Number	:	718-333-1398

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	RICHARD JAY APPLE
Credential	:	MD
Telephone Number	:	718-758-5220

Provider Enumeration Date	:	06/27/2015
Last Update Date	:	06/27/2015

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Directions to “APPLE PAIN MANGEMENT PLLC ” Practice Location

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