# SPINE AND PAIN MEDICAL PLLC

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

## Provider details

- **NPI number:** 1538510466
- **Authorized official:** MR. DAE KANG (BILLING MANAGER)
- **Authorized official phone:** (914) 681-9089

## Contact information

- **Practice address:** 83 MONTGOMERY AVE, SCARSDALE, NY 10583-5104
- **Practice address phone:** (914) 681-9089
- **Mailing address:** 200 S BROADWAY, SUITE 205, TARRYTOWN, NY 10591-4500
- **Mailing address phone:** (917) 572-7108

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 6143 | NY | Yes |

## Other

- **Enumeration date:** 06/22/2016
- **Last updated:** 06/22/2016