Organization · NPI-2

90th Street Surgical PLLC

Pain Medicine, Interventional Pain Medicine · New York, NY

NPI number1619795887
StatusActive
Last updated in NPPESSep 27, 2024

Details

NPI
1619795887
Entity type
Organization (NPI-2)
Legal business name
90th Street Surgical PLLC
Organization subpart
No
Enumeration date
Sep 27, 2024
Certification date
Sep 27, 2024
Last updated
Sep 27, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
208VP0014X Pain Medicine, Interventional Pain Medicine––Yes

Practice location

435 E 90th St Ste 201
New York, NY 10128-5103

Phone 315-302-9073

Mailing address

435 E 90th St Ste 201
New York, NY 10128-5103

Phone 315-302-9073

Authorized official

David Davydov
Director
3153029073

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Pain Medicine, Interventional Pain Medicine providers in New York, NY