# SPINE SPORTS & INTERVENTIONAL PAIN MEDICINE PC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043626435
- **Authorized official:** DR. SANJEEV AGARWAL MD (OWNER)
- **Authorized official phone:** (631) 486-9100

## Contact information

- **Practice address:** 186 MONTAGUE ST, BROOKLYN, NY 11201-3634
- **Practice address phone:** (718) 358-1700
- **Practice address fax:** (718) 489-4101
- **Mailing address:** 495 CENTRAL PARK AVE, SUITE 303, SCARSDALE, NY 10583-1068
- **Mailing address phone:** (914) 713-8774

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |
| 305S00000X | Point of Service | 2439891 | NY | — |

## Other

- **Enumeration date:** 07/07/2014
- **Last updated:** 01/03/2019