Provider Demographics
NPI:1356721070
Name:PAIN AND SPINE CARE
Entity type:Organization
Organization Name:PAIN AND SPINE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SAJID
Authorized Official - Middle Name:A
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-326-5397
Mailing Address - Street 1:470 CASTLEMAN RD
Mailing Address - Street 2:
Mailing Address - City:VESTAL
Mailing Address - State:NY
Mailing Address - Zip Code:13850-6138
Mailing Address - Country:US
Mailing Address - Phone:301-326-5397
Mailing Address - Fax:607-429-0244
Practice Address - Street 1:409 HOOPER RD
Practice Address - Street 2:
Practice Address - City:ENDWELL
Practice Address - State:NY
Practice Address - Zip Code:13760-3661
Practice Address - Country:US
Practice Address - Phone:301-326-5397
Practice Address - Fax:607-429-0244
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-08
Last Update Date:2015-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty