Provider Demographics
NPI:1790891356
Name:MANHATTAN SPINE & PAIN MEDICINE , P. C.
Entity Type:Organization
Organization Name:MANHATTAN SPINE & PAIN MEDICINE , P. C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:SANJAY
Authorized Official - Middle Name:
Authorized Official - Last Name:BAKSHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-535-3505
Mailing Address - Street 1:540 BORDENTOWN AVE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:SOUTH AMBOY
Mailing Address - State:NJ
Mailing Address - Zip Code:08879-1544
Mailing Address - Country:US
Mailing Address - Phone:732-721-7227
Mailing Address - Fax:
Practice Address - Street 1:115 E 57TH ST
Practice Address - Street 2:STE 610
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-2049
Practice Address - Country:US
Practice Address - Phone:212-535-3505
Practice Address - Fax:212-535-3568
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-23
Last Update Date:2010-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ113572Medicare PIN
NYA100000513Medicare PIN
G07201Medicare UPIN