Provider Demographics
NPI:1063642254
Name:WINTHROP PAIN MANAGEMENT
Entity Type:Organization
Organization Name:WINTHROP PAIN MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:KONDAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-838-2371
Mailing Address - Street 1:216 1ST STREET
Mailing Address - Street 2:
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501
Mailing Address - Country:US
Mailing Address - Phone:954-838-2371
Mailing Address - Fax:516-741-8276
Practice Address - Street 1:1300 FRANKLIN AVE
Practice Address - Street 2:2ND FLOOR 3A
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-1886
Practice Address - Country:US
Practice Address - Phone:516-741-0570
Practice Address - Fax:516-741-8276
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NASSAU ANESTHESIA ASSOCIATES, P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-07-22
Last Update Date:2019-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY208VP0000X207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty