# PETRYCHENKO PAIN MANAGEMENT PA

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

## Provider details

- **NPI number:** 1841860442
- **Authorized official:** DR. DMITRI PETRYCHENKO MD (PRESIDENT)
- **Authorized official phone:** (929) 320-7481

## Contact information

- **Practice address:** 2100 E HALLANDALE BEACH BLVD STE 210, HALLANDALE BEACH, FL 33009-3770
- **Practice address phone:** (212) 951-1238
- **Practice address fax:** (718) 336-5137
- **Mailing address:** 2100 E HALLANDALE BEACH BLVD STE 210, HALLANDALE BEACH, FL 33009-3770
- **Mailing address phone:** (212) 951-1238
- **Mailing address fax:** (718) 336-5137

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 174400000X | Specialist | — | NULL | — |
| 174400000X | Specialist | — | — | — |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | NULL | Yes |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/28/2021
- **Last updated:** 06/28/2021