# SPINE AND PAIN CONSULTANT, PLLC

> 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:** 1336643600
- **Authorized official:** KENNETH B CHAPMAN MD (DIRECTOR)
- **Authorized official phone:** (718) 667-3577

## Contact information

- **Practice address:** 1534 VICTORY BLVD, STATEN ISLAND, NY 10314-3548
- **Practice address phone:** (718) 667-3577
- **Practice address fax:** (718) 351-7151
- **Mailing address:** 1360 HYLAN BLVD, STATEN ISLAND, NY 10305-1922
- **Mailing address phone:** (718) 667-3577
- **Mailing address fax:** (718) 351-7151

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | 233952 | NY | Yes |
| 208VP0014X | Interventional Pain Medicine Physician | — | NULL | — |
| 208VP0014X | Interventional Pain Medicine Physician | — | — | — |

## Other

- **Enumeration date:** 03/21/2018
- **Last updated:** 01/27/2023