Provider Demographics
NPI:1003192139
Name:CENTRAL PAIN MEDICINE PLLC
Entity Type:Organization
Organization Name:CENTRAL PAIN MEDICINE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:DISCENZA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-771-9800
Mailing Address - Street 1:59 HALLEY DRIVE
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:NY
Mailing Address - Zip Code:10970-2101
Mailing Address - Country:US
Mailing Address - Phone:914-771-9800
Mailing Address - Fax:914-771-9855
Practice Address - Street 1:2150 CENTRAL PARK AVENUE
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10710-1856
Practice Address - Country:US
Practice Address - Phone:914-771-9800
Practice Address - Fax:914-771-9855
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-03
Last Update Date:2011-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYNY140670208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty