Provider Demographics
NPI:1023357654
Name:NEW YORK PAIN CONSULTANTS, LLC
Entity Type:Organization
Organization Name:NEW YORK PAIN CONSULTANTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:L
Authorized Official - Last Name:SHALMI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:631-422-6166
Mailing Address - Street 1:301 E MAIN ST
Mailing Address - Street 2:ENTENMANNS FAMILY CARDIAC CENTER-1ST FLR
Mailing Address - City:BAY SHORE
Mailing Address - State:NY
Mailing Address - Zip Code:11706-8408
Mailing Address - Country:US
Mailing Address - Phone:631-968-3660
Mailing Address - Fax:631-968-3670
Practice Address - Street 1:301 E MAIN ST
Practice Address - Street 2:ENTENMANNS FAMILY CARDIAC CENTER-1ST FLR
Practice Address - City:BAY SHORE
Practice Address - State:NY
Practice Address - Zip Code:11706-8408
Practice Address - Country:US
Practice Address - Phone:631-968-3660
Practice Address - Fax:631-968-3670
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-01
Last Update Date:2013-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY6726880003Medicare NSC