Organization · NPI-2

Pain Management Medical Associates PLLC

Anesthesiology, Pain Medicine · Fresh Meadows, NY

NPI number1649560921

StatusActive

Last updated in NPPESMay 19, 2013

Details

NPI: 1649560921
Entity type: Organization (NPI-2)
Legal business name: Pain Management Medical Associates PLLC
Organization subpart: No
Enumeration date: Apr 8, 2011
Last updated: May 19, 2013

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
207LP2900X	Anesthesiology, Pain Medicine	–	–	Yes

Practice location

7568 187th St
Fresh Meadows, NY 11366-1726

Phone 718-576-1999

Mailing address

57-55 Hewlett Street
Little Neck, NY 11362

Phone 718-576-1999 · Fax 718-423-2511

Authorized official

Hengameh Ardalan
Owner
3477242168

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