Provider Demographics
NPI:1619140134
Name:PAIN PHYSICIANS ASSOCIATES, PLLC.
Entity Type:Organization
Organization Name:PAIN PHYSICIANS ASSOCIATES, PLLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MEHRDAD
Authorized Official - Middle Name:
Authorized Official - Last Name:HEDAYATNIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-790-2661
Mailing Address - Street 1:2 CATHARINE ST
Mailing Address - Street 2:P.O. BOX 550
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-3100
Mailing Address - Country:US
Mailing Address - Phone:845-790-2661
Mailing Address - Fax:845-790-2675
Practice Address - Street 1:326 7TH ST
Practice Address - Street 2:PARK SLOPE PHYSICIAN ASSOCIATES
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-3311
Practice Address - Country:US
Practice Address - Phone:718-965-1234
Practice Address - Fax:845-790-2675
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-04
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty