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Organization
PAIN AND SPORT MEDICINE OF NEW YORK PC
Active
Organization
PAIN AND SPORT MEDICINE OF NEW YORK PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JANE YANG (BILLING)
(212) 925-8839
Entity
Organization
Contact information
Practice address
32 E BROADWAY RM 501, NEW YORK, NY 10002-6891
(212) 925-8839
(212) 226-8498
Mailing address
32 E 76TH ST APT 804, NEW YORK, NY 10021-2754
(212) 925-8839
(212) 226-8498
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
204326
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10210203
AMERIGROUP
NY
01
—
149219
WELLCARE
NY
05
—
1888811
—
NY
01
—
2493590
AETNA
NY
01
—
2I2493
BLUE CROSS BLUE SHIELD
NY
01
—
P646923
OXFORD
NY
Enumeration date
04/03/2007
Last updated
10/10/2007
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