# S. PATHARE, M.D., PLLC

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

## Provider details

- **NPI number:** 1629867890
- **Authorized official:** DR. SHAILESH PATHARE MD (OWNER)
- **Authorized official phone:** (718) 701-6010

## Contact information

- **Practice address:** 565 JEWETT AVE, STATEN ISLAND, NY 10302-2654
- **Practice address phone:** (718) 701-6010
- **Mailing address:** 565 JEWETT AVE, STATEN ISLAND, NY 10302-2654
- **Mailing address phone:** (718) 701-6010

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | — |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | NULL | Yes |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | — | Yes |
| 2083A0300X | Addiction Medicine (Preventive Medicine) Physician | — | NULL | — |
| 2083A0300X | Addiction Medicine (Preventive Medicine) Physician | — | — | — |

## Other

- **Enumeration date:** 05/05/2025
- **Last updated:** 05/05/2025