Pain Management Of Richmond County
Clinic/Center, Ambulatory Surgical in Staten Island, NY. Organization (NPI-2).
NPI number1073652467
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1073652467
- Entity type
- Organization (NPI-2)
- Legal business name
- Pain Management Of Richmond County
- Organization subpart
- No
- Enumeration date
- Feb 5, 2007
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QA1903X | Clinic/Center, Ambulatory Surgical | NY128904 | NY | Yes |
Practice location
3225 Victory BlvdStaten Island, NY 10314-6703
Phone 718-980-9840 · Fax 718-980-9843
Mailing address
3225 Victory BlvdStaten Island, NY 10314-6703
Phone 718-980-9840 · Fax 718-980-9843
Authorized official
Brian Anthony Maloney
Medical Officier
7189809840
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