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NPI Code Detail

MEDICARE: PAIN PHYSICIANS ASSOCIATES, PLLC.

MEDICARE: PAIN PHYSICIANS ASSOCIATES, 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) PhysicianNY

General Provider Information

NPI Number : 1619140134
Entity Type Code : Organization
Provider Name (Legal Business Name) : PAIN PHYSICIANS ASSOCIATES, PLLC.
Provider Business Mailing Address
First Line : 2 CATHARINE ST
Second Line : P.O. BOX 550
City : POUGHKEEPSIE
State : NY
Zip : 12601-3100
Country : US
Telephone Number : 845-790-2661
Fax Number : 845-790-2675
Provider Business Practice Location Address
First Line : 326 7TH ST
Second Line : PARK SLOPE PHYSICIAN ASSOCIATES
City : BROOKLYN
State : NY
Zip : 11215-3311
Country : US
Telephone Number : 718-965-1234
Fax Number : 845-790-2675
Authorized Official
Title or Position : OWNER
Name : MEHRDAD HEDAYATNIA
Credential : MD
Telephone Number : 845-790-2661
Provider Enumeration Date : 04/04/2008
Last Update Date : 07/21/2022

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