# SPINE AND PAIN CONSULTANT, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** SPINE AND PAIN CONSULTANT, PLLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1043785181
- **Legal business name:** SPINE AND PAIN CONSULTANT, PLLC
- **Authorized official:** KENNETH B CHAPMAN MD (MEDICAL DIRECTOR)
- **Authorized official phone:** (718) 667-3577

## Contact information

- **Practice address:** 860 5TH AVE STE 1B, NEW YORK, NY 10065-5856
- **Practice address phone:** (212) 724-7246
- **Mailing address:** 1360 HYLAN BLVD, STATEN ISLAND, NY 10305-1922
- **Mailing address phone:** (718) 667-3577

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | NULL | Yes |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | — | Yes |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | NULL | — |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | — | — |
| 208VP0014X | Interventional Pain Medicine Physician | — | NULL | — |
| 208VP0014X | Interventional Pain Medicine Physician | — | — | — |

## Other

- **Enumeration date:** 10/04/2018
- **Last updated:** 01/27/2023