# ATLANTIC ANESTHESIA /PAIN MANAGEMENT MEDICAL SERVICES P.C.

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

## Provider details

- **NPI number:** 1366692527
- **Authorized official:** DR. DMITRY MIRONOV MD (PRESIDENT)
- **Authorized official phone:** (212) 781-4720

## Contact information

- **Practice address:** 436 FORT WASHINGTON AVE, SUITE 1H, NEW YORK, NY 10033-3507
- **Practice address phone:** (212) 781-4720
- **Practice address fax:** (212) 923-9585
- **Mailing address:** 436 FORT WASHINGTON AVE, SUITE 1H, NEW YORK, NY 10033-3507
- **Mailing address phone:** (212) 781-4720
- **Mailing address fax:** (212) 923-9585

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | 214351 | NY | Yes |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | 214351 | NULL | — |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | 214351 | — | — |

## Other

- **Enumeration date:** 09/24/2008
- **Last updated:** 08/04/2009