# KNOX PAIN MANAGEMENT MEDICAL PRACTICE PLLC

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

## Provider details

- **NPI number:** 1104593870
- **Authorized official:** JENNY NEWCOMB (OFFICE)
- **Authorized official phone:** (631) 736-4064

## Contact information

- **Practice address:** 340 ROUTE 202, SOMERS, NY 10589-3237
- **Practice address phone:** (845) 254-1155
- **Practice address fax:** (631) 736-1332
- **Mailing address:** 340 ROUTE 202, SOMERS, NY 10589-3237
- **Mailing address phone:** (845) 254-1155
- **Mailing address fax:** (631) 736-1332

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | NULL | Yes |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/30/2021
- **Last updated:** 09/09/2021