Provider Demographics
NPI:1871846683
Name:INTEGRATED PAIN AND REHABILITATION SOLUTIONS, PLLC
Entity Type:Organization
Organization Name:INTEGRATED PAIN AND REHABILITATION SOLUTIONS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO / PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NASAR
Authorized Official - Middle Name:M
Authorized Official - Last Name:SHAHID
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-907-5094
Mailing Address - Street 1:29 SYCAMORE LN
Mailing Address - Street 2:
Mailing Address - City:COMMACK
Mailing Address - State:NY
Mailing Address - Zip Code:11725-2329
Mailing Address - Country:US
Mailing Address - Phone:631-697-4358
Mailing Address - Fax:
Practice Address - Street 1:29 SYCAMORE LN
Practice Address - Street 2:
Practice Address - City:COMMACK
Practice Address - State:NY
Practice Address - Zip Code:11725-2329
Practice Address - Country:US
Practice Address - Phone:201-907-5094
Practice Address - Fax:347-620-3517
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-17
Last Update Date:2020-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY216092208100000X, 2081P0004X, 2081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
No2081P0004XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSpinal Cord Injury MedicineGroup - Single Specialty
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Single Specialty