Provider Demographics
NPI:1346505096
Name:METRO PAIN SPECIALISTS PC
Entity Type:Organization
Organization Name:METRO PAIN SPECIALISTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LEONID
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAPIRO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-803-0191
Mailing Address - Street 1:790 BLOOMFIELD AVE
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07012-1142
Mailing Address - Country:US
Mailing Address - Phone:201-448-4100
Mailing Address - Fax:
Practice Address - Street 1:790 BLOOMFIELD AVE
Practice Address - Street 2:SUITE 1A
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07012-1142
Practice Address - Country:US
Practice Address - Phone:201-448-4100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-09
Last Update Date:2018-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY213535207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1346505096OtherNPI