# PAIN MANAGEMENT MEDICAL ASSOCIATES PLLC

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

## Provider details

- **NPI number:** 1649560921
- **Authorized official:** DR. HENGAMEH ARDALAN M.D. (OWNER)
- **Authorized official phone:** (347) 724-2168

## Contact information

- **Practice address:** 7568 187TH ST, FRESH MEADOWS, NY 11366-1726
- **Practice address phone:** (718) 576-1999
- **Mailing address:** 57-55 HEWLETT STREET, LITTLE NECK, NY 11362
- **Mailing address phone:** (718) 576-1999
- **Mailing address fax:** (718) 423-2511

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | NULL | Yes |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/08/2011
- **Last updated:** 05/19/2013